Epidemiology and management of common pulmonary diseases in older persons

Abstract

Pulmonary disease prevalence increases with age and contributes to morbidity and mortality in older patients. Dyspnea in older patients is often ascribed to multiple etiologies such as medical comorbidities and deconditioning. Common pulmonary disorders are frequently overlooked as contributors to dyspnea in older patients. In addition to negative impacts on morbidity and mortality, quality of life is reduced in older patients with uncontrolled, undertreated pulmonary symptoms. The purpose of this review is to discuss the epidemiology of common pulmonary diseases, namely pneumonia, chronic obstructive pulmonary disease, asthma, lung cancer, and idiopathic pulmonary fibrosis in older patients. We will review common clinical presentations for these diseases and highlight differences between younger and older patients. We will also briefly discuss risk factors, treatment, and mortality associated with these diseases. Finally, we will address the relationship between comorbidities, pulmonary symptoms, and quality of life in older patients with pulmonary diseases.

Figures

Figure 1.

Prevalence of COPD by age group in the United States. Data from National Health Interview Survey, 2000 (45).

Figure 2.

Prevalence of current asthma among men and women 1–85 years, by age: United States, annual average 2001–2009 (157).

Figure 3.

Incidence rates of lung cancer by age group. Data from United States, 2007 SEER database (191).

Figure 4.

Onset of idiopathic pulmonary fibrosis (IPF) usually occurs between the ages of 50 and 70 years, but the mean age in this population of patients with IPF was 61.4 years (n = 238, age range 27–79 years). Data from cohort of patients enrolled between 1982 and 1996 in the Specialized Center of Research Study at the National Jewish Medical and Research Center. Reproduced with permission from the American College of Chest Physicians (246).

Figure 5.

Percentage of lung transplant recipients age 65 years and older in the United States from 1999 to 2008 (278).