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Pulmonary Disease

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Geriatric Medicine

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Abstract

A multitude of changes occur in the lung with normal aging. There are age-related immune defects called “immunosenescence” and age-associated inflammation or “inflammaging.” Elevated levels of pro-inflammatory cytokines and increased airway neutrophils can be seen in healthy elderly adults. Structural changes occur in the aging lung and thoracic cage that result in reduced lung function. These include a loss of elastic recoil of the lung, stiffening of the chest wall, as well as kyphosis of the spine. Furthermore, genetic damage results from a lifetime of exposure to external insults and processes that stabilize and repair DNA are impaired. One notable example is telomere attrition, a feature of normal aging, but is also implicated in several diseases such as emphysema and pulmonary fibrosis. Epigenetic changes that affect gene expression are also strongly implicated in chronic lung diseases and lung cancer.

The main chronic lung diseases seen in the elderly population are asthma, chronic obstructive pulmonary disease, and interstitial lung disease such as idiopathic pulmonary fibrosis (IPF). Optimal management of chronic diseases in the elderly take into the account the severity of disease, the patient’s functional capacity, and personal preferences. As comorbidities are common in this population, competing risks of other illness must be considered when therapeutic choices are made. A person-centered approach to each disease state is essential for the patient and often the family caregiver.

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Author information

Authors and Affiliations

  1. The Johns Hopkins University School of Medicine, Baltimore, USA

    Stacey-Ann Whittaker Brown

  2. Icahn School of Medicine at Mount Sinai, The Warren Alpert Medicine School of Brown University, Highland Beach, USA

    Sidney S. Braman

Authors
  1. Stacey-Ann Whittaker Brown
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  2. Sidney S. Braman
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Correspondence to Sidney S. Braman .

Editor information

Editors and Affiliations

  1. California Association of Long Term Care Medicine, Newbury Park, CA, USA

    Michael R. Wasserman

  2. Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA

    Debra Bakerjian

  3. Department of Clinical Pharmacy, University of Colorado School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA

    Sunny Linnebur

  4. Division of Geriatrics, SUNY Upstate Medical University, Syracuse, NY, USA

    Sharon Brangman

  5. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari

  6. Section of Geriatric Medicine, Division of Internal Medicine, Department of Medicine, Cedars-Sinai, Beverly Hills, CA, USA

    Sonja Rosen

Section Editor information

  1. California Association of Long Term Care Medicine, Newbury Park, CA, USA

    Michael R. Wasserman M.D., CMD

  2. Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy

    Matteo Cesari MD, PhD

  3. Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

    Matteo Cesari MD, PhD

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Whittaker Brown, SA., Braman, S.S. (2023). Pulmonary Disease. In: Wasserman, M.R., Bakerjian, D., Linnebur, S., Brangman, S., Cesari, M., Rosen, S. (eds) Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-01782-8_55-1

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