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Translating Basic Research Into Clinical PracticeThe Aging Lung: Is Lung Health Good Health for Older Adults?
Section snippets
Physiologic Changes in the Aging Lung
Although the number of alveoli, alveolar ducts, and capillary segments are stable once adulthood is reached6 and total lung volume remains the same,4, 5 physiologic changes in the aging lung occur that decrease functional capacity. For example, alveolar and alveolar-capillary surface area increases6 while elasticity decreases,4 resulting in an increase in resting functional residual capacity and an increase in end-expiratory lung volume.8 In healthy older adults, these functional changes may
Cellular Changes in the Aging Lung
The list of insults our lungs will face over the course of an average life includes particulates, ozone, aerosols, infections (and possibly overexuberant immune responses), allergens, and pollutants. Some people will have longer lists that will include, by choice or by chance, cigarette smoke, radiation, drugs and medications, mechanical injury, and exposure to industrial pollutants. Consequently, tissue repair is of paramount importance in the lungs as we age. Inappropriate or ineffective
The Relationship Between Lung Health and Other Age-Related Diseases
Maximum lung capacity is generally reached in one’s mid-twenties and remains stable for a decade, or in a fortunate few, for 2 decades. Lung capacity begins to decline in mid-life. This decline is steeper for those with lung disease and for smokers; however, even among those who have never smoked, there is considerable variation in both maximal lung capacity and the subsequent rate of decline.81, 82 The observation that having above-average lung capacity is a predictor of good health and that
Lung Health Is Good Health for Older Adults
Lung health is intimately associated with good health in older adults. Robust lung function correlates with a higher basal metabolic rate, which is associated with keeping trim in our later years,118 and with activity and physical performance.119 As discussed earlier, having lung disease or pneumonia can accelerate the development of other, seemingly unrelated chronic conditions. Collectively, the data are clear—healthy lungs contribute to a long and healthy life—but how can we capitalize on
Acknowledgments
Financial/nonfinancial disclosures: The author has reported to CHEST the following: D. M. E. B. is the Canada Research Chair in Aging and Immunity and is funded by the Canadian Institutes of Health Research, the Natural Sciences and Engineering Research Council of Canada, and the The Lung Association - Ontario. Research in the Bowdish laboratory is supported by the McMaster Immunology Research Centre and the M. G. DeGroote Institute for Infectious Disease Research.
Other contributions: The
References (121)
- et al.
Effects of pulmonary function on mortality
J Chron Dis
(1985) - et al.
Detection of age-dependent changes in healthy adult lungs with diffusion-weighted 3He MRI
Acad Radiol
(2005) - et al.
Spirometry reference values for healthy elderly blacks. The Cardiovascular Health Study Research Group
Chest
(1996) - et al.
Risk factors and early origins of chronic obstructive pulmonary disease
Lancet
(2015) - et al.
Performance of American Thoracic Society-recommended spirometry reference values in a multiethnic sample of adults: the Multi-Ethnic Study of Atherosclerosis (MESA) lung study
Chest
(2010) The effects of aging on lung structure and function
Clinics Geriatr Med
(2017)- et al.
Predisposition for disrepair in the aged lung
Am J Med Sci
(2012) - et al.
Leukocyte compartments in the mouse lung: distinguishing between marginated, interstitial, and alveolar cells in response to injury
J Immunol Methods
(2012) - et al.
The unmet need in the elderly: how immunosenescence, CMV infection, co-morbidities and frailty are a challenge for the development of more effective influenza vaccines
Vaccine
(2012) - et al.
Immunosenescence in monocytes, macrophages, and dendritic cells: lessons learned from the lung and heart
Immunol Lett
(2014)
Neutrophils and low-grade inflammation in the seemingly normal aging human lung
Mech Ageing Dev
Circulating TNF and mitochondrial DNA are major determinants of neutrophil phenotype in the advanced-age, frail elderly
Mol Immunol
Immunosenescence: influenza vaccination and the elderly
Curr Opin Immunol
Epidemiology and long-term clinical and biologic risk factors for pneumonia in community-dwelling older Americans: analysis of three cohorts
Chest
Elevated A20 contributes to age-dependent macrophage dysfunction in the lungs
Exp Gerontol
Phosphoinositide 3-kinase inhibition restores neutrophil accuracy in the elderly: toward targeted treatments for immunosenescence
Blood
Aberrant neutrophil functions in stable chronic obstructive pulmonary disease: the neutrophil as an immunotherapeutic target
Int Immunopharmacol
Spirometric findings and mortality in never-smokers
J Clin Epidemiol
Lung function in type 2 diabetes: the Normative Aging Study
Respir Med
Reduced pulmonary function and its associations in type 2 diabetes: the Fremantle Diabetes Study
Diabetes Res Clin Pract
Leptin, obesity, and respiratory function
Respir Physiol
Multimorbidity in general practice: prevalence, incidence, and determinants of co-occurring chronic and recurrent diseases
J Clin Epidemiol
Associations of elevated interleukin-6 and C-reactive protein levels with mortality in the elderly
Am J Med
Quantification of biological aging in young adults
Proc Natil Acad Sci U S A
Impaired pulmonary function as a risk factor for mortality
Am J Epidemiol
Elasticity of human lungs in relation to age
J Appl Physiol
The relationship between airway resistance, airway conductance and lung volume in subjects of different age and body size
J Clin Invest
Architecture of the human lung. Use of quantitative methods establishes fundamental relations between size and number of lung structures
Science
Progressive mechanical ventilatory constraints with aging
Am J Respir Crit Care Med
Spirometric reference equations for European females and males aged 65-85 yrs
Eur Respir J
Airspace size in lungs of lifelong non-smokers: effect of age and sex
Thorax
The intersection of aging biology and the pathobiology of lung diseases: a joint NHLBI/NIA workshop
J Gerontol A Biol Sci Med Sci
Sequencing of idiopathic pulmonary fibrosis-related genes reveals independent single gene associations
BMJ Open Respir Res
Emerging therapies for idiopathic pulmonary fibrosis, a progressive age-related disease
Nat Rev Drug Discov
IPF lung fibroblasts have a senescent phenotype
Am J Physiol Lung Cell Mol Physiol
Mitochondria in the spotlight of aging and idiopathic pulmonary fibrosis
J Clin Invest
Aging and cigarette smoke: fueling the fire
Am J Respir Crit Care Med
Airspace enlargement with airway cell apoptosis in Klotho mice: a model of aging lung
J Gerontol A Biol Sci Med Sci
Age-related changes in lung structure and function in the senescence-accelerated mouse (SAM): SAM-P/1 as a new murine model of senile hyperinflation of lung
Am J Respir Crit Care Med
Ventilatory response to exercise in subjects breathing CO2 or HeO2
J Appl Physiol
Demand vs. capacity in the aging pulmonary system
Exerc Sport Sci Rev
Lung volume reference values for women and men 65 to 85 years of age
Am J Respir Crit Care Med
Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers
Eur Respir J
Age- and height-based prediction bias in spirometry reference equations
Eur Respir J
Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations
Eur Respir J
Spirometric reference values from a sample of the general US population
Am J Respir Crit Care Med
The three R's of lung health and disease: repair, remodeling, and regeneration
J Clin Invest
Surfactant protein-C chromatin-bound green fluorescence protein reporter mice reveal heterogeneity of surfactant protein C-expressing lung cells
Am J Respir Cell Mol Biol
Isolation of epithelial, endothelial, and immune cells from lungs of transgenic mice with oncogene-induced lung adenocarcinomas
Am J Respir Cell Mol Biol
Identification and isolation of mouse type II cells on the basis of intrinsic expression of enhanced green fluorescent protein
Am J Physiol Lung Cell Mol Physiol
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