Respiratory Diseases in the Elderly

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk


Normal physiological and structural changes occur in the respiratory system with ageing due to changes in pulmonary mechanics, respiratory muscle strength and ventilation control. There is an increase in pulmonary vascular stiffness, vascular pressures and vascular resistance associated with ageing. The thoracic cage becomes rigid and stiff with decrease chest movement shifting chest wall pressure-volume curve to the right. Changes in the airways contribute to increased chances of infection, increased residual volume and residual functional capacity and decreased vital capacity. Ventilation control diminishes with reduced response to hypoxia and hypercapnia.

The respiratory diseases included in this chapter are pneumonia, chronic obstructive airways disease, asthma, lung cancer and pulmonary embolism. Pneumonia is one of the most common infections in the elderly. In the elderly there is a greater susceptibility to infection because of the age-related decline in immune response. Ageing of the population and past smoking are the major causes of the increase in COPD. There have been several attempts to define asthma subtypes, and cluster analyses had identified different adult-onset asthma phenotype. Adult-onset asthma has notable eosinophilia, patterns of interleukins (IL) and TH2 pathway, but generally allergic disease assume less importance. Pulmonary embolism (PE) incidence, prevalence and mortality increase steadily with age. PE is predominantly a disease of the elderly and is often underdiagnosed.


Elderly Age-related changes Pathophysiology Pulmonary mechanics Ventilation control Respiratory muscle strength 


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 2
  • Gary Cheuk
    • 3
  1. 1.Sydney Medical School (Westmead)The University of SydneyNorth RocksAustralia
  2. 2.Norwest Specialist Medical GroupBella VistaAustralia
  3. 3.Blacktown-Mt Druitt HospitalBlacktownAustralia

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