• Claudio Sorino, Claudio Pedone, and Nicola Scichilone.
• Biomedical Department of Internal and Specialist Medicine, Section of Pulmonology, University of Palermo, Italy; Division of Pulmonology, ASST Lariana S. Anna Hospital of Como, Italy. Electronic address: claudiosorino@libero.it.
• Eur. J. Intern. Med. 2016 Oct 1; 34: 72-77.

BackgroundThe coexistence of asthma and chronic obstructive pulmonary disease (asthma-COPD overlap syndrome: ACOS) is increasingly recognized but data about its prevalence and long-term mortality are needed.MethodsPrevalence of ACOS and 15-year mortality rates were assessed in 1065 subjects aged >65years, enrolled in the SA.R.A. study, with complete clinical, lung functional and follow-up data. Physical performance, disease-related disability, and health-related quality of life (HRQL) were also evaluated.ResultsACOS was found in 11.1% of subjects (29.4% of those previously diagnosed with COPD and 19.7% of those with asthma). ACOS was positively associated with impaired physical performance, functional ability, and HRQL. Individuals with ACOS had higher mortality rates than controls (7.17 per 100 person-years; mortality rate ratio: 1.83). After adjustment for the main confounders, the risk of all-cause mortality remained significantly increased in subjects with ACOS (HR: 1.82), COPD (HR: 2.12), and restriction (HR: 2.41), but not asthma.ConclusionsLong-term prognosis of ACOS was similar to COPD, and worse than asthma and healthy controls. ACOS had a significant impact on physical performance, functional ability, and HRQL.Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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