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Review
. 2006;1(3):253-60.
doi: 10.2147/ciia.2006.1.3.253.

Effect of aging on respiratory system physiology and immunology

Gulshan Sharma  1 , James Goodwin
Affiliations
Review

Effect of aging on respiratory system physiology and immunology

Gulshan Sharma et al. Clin Interv Aging. 2006.

Abstract

With the looming expansion of the elderly population of the US, a thorough understanding of "normal" aging-related changes on the respiratory system is paramount. The respiratory system undergoes various anatomical, physiological and immunological changes with age. The structural changes include chest wall and thoracic spine deformities which impairs the total respiratory system compliance leading to increase work of breathing. The lung parenchyma loses its supporting structure causing dilation of air spaces: "senile emphysema". Respiratory muscle strength decreases with age and can impair effective cough, which is important for airway clearance. The lung matures by age 20-25 years, and thereafter aging is associated with progressive decline in lung function. The alveolar dead space increases with age, affecting arterial oxygen without impairing the carbon dioxide elimination. The airways receptors undergo functional changes with age and are less likely to respond to drugs used in younger counterparts to treat the same disorders. Older adults have decreased sensation of dyspnea and diminished ventilatory response to hypoxia and hypercapnia, making them more vulnerable to ventilatory failure during high demand states (ie, heart failure, pneumonia, etc) and possible poor outcomes.

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Figures

Figure 1
Figure 1
Effect of environmental exposure on airways.
Figure 2
Figure 2
Relationship between lung volumes and lung capacities. Abbreviations: ERV, expiratory reserve volume; FRC, functional residual capacity; IC, inspiratory capacity; IRV, inspiratory reserve volume; RV, residual volume; TLC, total lung capacity; TV, total volume; VC, vital capacity.
Figure 3
Figure 3
Age-related decline in forced expiratory volume in one second (FEV1)% predicted plotted as % of maximal at age 20 years against age. Note: Adapted from Ware JH, Dockery DW, Louis TA, et al. 1990. Longitudinal and cross-sectional estimates of pulmonary function decline in never-smoking adults. Am J Epidemiol, 132:685-700. Copyright © 2004. Reprinted with permission from Oxford University Press.
Figure 4
Figure 4
Mechanism of action of beta agonist. Abbreviations: ATP, adenosine triphosphate; cAMP, cyclic adenosine monophosphate.
See this image and copyright information in PMC

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