Insights from the Tasmanian Longitudinal Health Study Identifies Treatable Traits in Adult Cough Subclasses

Cough is a prevalent yet complex condition with distinct subclasses, but its characteristics and progression over time remain poorly understood in general populations. This study analyzed data from the Tasmanian Longitudinal Health Study (TAHS), a prospective community-based cohort that began in 1968, following participants from childhood to midlife. We aimed to identify cough subclasses among adults and explore their clinical features and lung function trajectories over six decades.

Data were collected from 8,583 baseline participants, with 6,128 traced and invited for follow-up between 2012 and 2016. Of the 3,609 respondents, 2,213 were identified as current coughers and classified into six cough subclasses through latent class analysis: minimal cough (9.3%), cough with colds only (53.7%), cough with allergies (13.8%), intermittent productive cough (9.6%), chronic dry cough (6.6%), and chronic productive cough (6.9%). Chronic and intermittent productive coughers had significantly worse lung function trajectories, such as persistent low FEV1 and early low-rapid decline in FEV1/FVC, compared to those with minimal cough.

These findings reveal distinct treatable traits across cough subclasses, such as asthma, allergies, and smoking, particularly in productive cough types. They underscore the need for tailored management strategies in primary care, including routine spirometry for productive cough, distinct from those used for dry cough, suggesting that future studies could refine cough management in community settings.