Chest
Volume 155, Issue 2, February 2019, Pages 391-400
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Translating Basic Research Into Clinical Practice
The Aging Lung: Is Lung Health Good Health for Older Adults?

https://doi.org/10.1016/j.chest.2018.09.003Get rights and content

The prevalence of lung conditions, such as COPD and pulmonary fibrosis, and lung infections, such as pneumonia, increases sharply with age. The physiologic, cellular, and immunologic changes that occur during aging contribute to the development of lung disease. Studies of age-related changes in physiology and function are not only key to preventing or ameliorating disease, they are also essential for understanding healthy aging. Individuals with good lung function live longer, healthier lives, although the mechanisms by which this scenario occurs are not understood. The present article reviews changes in the aging lung that facilitate development of disease and the evidence supporting the idea that robust lung function reduces the risk of developing chronic inflammatory conditions that occur with age.

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

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