Article

Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion.

Outpatient Section of the Division of Pulmonary Diseases, Geneva University Hospital, 1211 Geneva 14, Switzerland.
Clinics in Chest Medicine (Impact Factor: 2.07). 10/2005; 26(3):469-84, vi-vii. DOI: 10.1016/j.ccm.2005.05.004
Source: PubMed

ABSTRACT Normal aging of the respiratory system is associated with a decrease in static elastic recoil of the lung, in respiratory muscle performance, and in compliance of the chest wall and respiratory system, resulting in increased work of breathing compared with younger subjects and a diminished respiratory reserve in cases of acute illness, such as heart failure, infection, or airway obstruction. In spite of these changes, the respiratory system remains capable of maintaining adequate gas exchange at rest and during exertion during the entire lifespan, with only a slight decrease in Pa(O2) and no significant change in Pa(CO2).

2 Bookmarks
 · 
522 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic obstructive pulmonary disease (COPD) is common in older people, with an estimated prevalence of 10% in the US population aged ≥75 years. Inhaled medications are the cornerstone of treatment for COPD and are typically administered by one of three types of devices, ie, pressurized metered dose inhalers, dry powder inhalers, and nebulizers. However, age-related pulmonary changes may negatively influence the delivery of inhaled medications to the small airways. In addition, physical and cognitive impairment, which are common in elderly patients with COPD, pose special challenges to the use of handheld inhalers in the elderly. Health care providers must take time to train patients to use handheld inhalers and must also check that patients are using them correctly on a regular basis. Nebulizers should be considered for patients unable to use handheld inhalers properly. What follows is a review of issues associated with COPD and its treatment in the elderly patient.
    Clinical Interventions in Aging 01/2014; 9:23-30. · 2.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To investigate effects of older age, comorbidities, and physiological measures on outcomes of elderly adults requiring prolonged mechanical ventilation (PMV). Retrospective cohort study. Public long-term acute care hospital (LTACH) with an active program for ventilator weaning from PMV. Chronically seriously ill individuals with PMV aged 65 and older divided into six cohorts (65-69, 70-74, 75-79, 80-84, 85-89, ≥90) for comparative purposes (n = 540). Main outcomes were weaning criteria met, weaning success, discharge dispositions, and long-term survival. Other outcomes included weaning duration, LTACH days, discharge physical function, tracheostomy decannulation, and relapses to ventilator support. Weaning success was defined as 4 weeks or longer entirely free from mechanical ventilator support. The main finding from age cohort comparisons was that the likelihood of meeting weaning criteria (P = .001) and subsequent successful weaning (P = .002) decreased with age. Best predictors for weaning success in multivariable analysis were lower comorbidity burden (P < .001) and less-severe illness (P = .001). Other clinically important predictors were more-normal values in the respiratory physiology measures of rapid shallow breathing (P = .001) and static compliance (P = .003). Successful weaning was also associated with a 62% lower risk of death (P < .001). Although meeting weaning criteria and being successfully weaned decreased with increasing age, age was not the dominant factor in predicting outcomes. More importantly, individuals with PMV with better respiratory physiology and lower comorbidity burdens were more likely to be weaned and have longer survival, no matter their age.
    Journal of the American Geriatrics Society 01/2014; · 3.98 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Life expectancy is assumed to rise continuously and consequently global burden of age-associated diseases is expected to increase. All vital organs begin to lose some function during ageing with different rates, and the same happens on the lung. Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease of the lungs, which progresses very slowly and the majority of patients are therefore elderly. COPD is a major and increasing global health problem with enormous amount of expenditure of indirect/direct health care costs, and therefore, there is urgent need to clarify the molecular mechanism of COPD and develop novel treatments. We here hypothesize that environmental gases, such as cigarette smoke and kitchen pollutants, may accelerate the ageing of lung or worsen ageing-related events in the lung, leading to defective resolution of inflammation, reduced anti-oxidant capacity and defective disposal of abnormal proteins, and this consequently induces progression of COPD. Recent studies identified some anti-ageing small molecules (geroprotectors) that may open up new avenues for the treatment of COPD.
    Experimental gerontology 04/2014; · 3.34 Impact Factor

Full-text

View
21 Downloads
Available from