DEAR DR. ROACH: DEAR DR. ROACH: What tests check for emphysema? Are they the same tests for COPD? My age is 80. — P.T.

ANSWER: There are two main forms of chronic obstructive pulmonary disease: chronic bronchitis and emphysema. The main risk factor is cigarette smoking, but there are other risk factors, including a genetic condition, alpha-1-antitrypsin deficiency.

COPD is the fourth-leading cause of death in the U.S., and it gets a shockingly low amount of research money for such an important condition. Diagnosing COPD early is important in order to relieve symptoms, prevent hospitalizations and improve the quality of life and survival rates.The diagnosis of COPD should be suspected when there are classic symptoms. Shortness of breath, chronic cough (sometimes productive), wheezing and fatigue all may be present. Some people with COPD reduce their activities without realizing the degree to which they have become limited.

The diagnosis of COPD is usually confirmed by tests of lung function; spirometry may be done in the physician’s office, but formal pulmonary function testing in the lab gives a definitive answer. Testing is done only to confirm a clinical diagnosis. Pulmonary function testing is expensive and time-consuming and can lead to inappropriate diagnoses if done indiscriminately.

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