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Pulmonary Disease

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Geriatric Medicine

Abstract

The opportunities provided by clinical presentations of an older patient with pulmonary problems are both challenging and rewarding, often demonstrating classic examples of the geriatric paradigm, with interaction of primary, secondary, and tertiary risk factors. The primary risk factors are the changes of expected/anticipated aging, the secondary factors relate to particular disease processes, and the tertiary factors are the modifiable aspects of the patient’s life and illness, for example, exercise, diet, psychological issues, alcohol use, poverty, and, in particular for lung disease, cigarettes.

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References

  1. Connolly MJ, Crowley J J, Charan NB, et al. Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale. Thorax. 1992; 47: 410–413.

    Article  PubMed  CAS  Google Scholar 

  2. Krumpe PE, Knudson RJ, Parsons G, et al. The aging respiratory system. Clin Geriatr Med. 1985; 1: 143–175.

    PubMed  CAS  Google Scholar 

  3. Petty TL. It’s never too late to stop smoking, but how old are your lungs? JAMA. 1993; 269: 27–85.

    Google Scholar 

  4. Ibbotson SH, Tate GH, Davies JA. Thrombin activity by intrinsic activation of plasma in vitro acceleration with increasing age of the donor. Thromb Haemost. 1992; 67: 377–380.

    PubMed  CAS  Google Scholar 

  5. Hirsch J. Pulmonary embolism in the elderly. Cardiol Clin. 1991; 9: 457–474.

    Google Scholar 

  6. PIOPED Investigators. Valve of the ventilation/perfusion scan in acute pulmonary embolism: results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990; 263: 2753–2759.

    Article  Google Scholar 

  7. McFarlane MJ, Imperiale TF. Use of the alveolar-arterial oxygen gradient in the diagnosis of pulmonary embolism. Am J Med. 1994; 41: 57–62.

    Article  Google Scholar 

  8. Mclntyre K, Sasahara AA. The ratio of pulmonary arterial pressure to pulmonary vascular obstruction. Chest. 1977; 71: 692–698.

    Article  Google Scholar 

  9. White RH, McGahan JP, Daschbach MM, et al. Diagnosis of deep vein thrombosis using duplex ultrasound. Ann Intern Med. 1989; 111: 297–304.

    PubMed  CAS  Google Scholar 

  10. Kniffin WD, Baron JA, Barrett J, et al. The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med. 1994; 154: 861–866.

    Article  PubMed  Google Scholar 

  11. Goldhaber SZ, Kessler CM, Heit J, et al. Randomized controlled trial of recombinant tissue plasminogen activator versus urokinase in the treatment of acute pulmonary embolism. Lancet. 1988; 2: 293–298.

    Article  PubMed  CAS  Google Scholar 

  12. Clagett GP, Anderson FA, Levine MN, et al. Prevention of venous thromboembolism. Chest. 1992; 102: 3915–4075.

    Google Scholar 

  13. Wade JF, King TE. Infiltrative and interstitial lung disease in the elderly patient. Clin Chest Med. 1993; 14: 501–521.

    PubMed  Google Scholar 

  14. Schwartz MF, King TE, eds. Interstitial Lung Disease. Toronto: B.C. Deeber; 1988.

    Google Scholar 

  15. Winterbauer RH. The treatment of ideopathic pulmonary fibrosis. Chest 1991; 100: 233–240.

    Article  PubMed  CAS  Google Scholar 

  16. Rosenow EC III, Meyers JL, Swensen SJ, Pisami RJ. Drug induced pulmonary disease: an update. Chest. 1992; 102: 239–250.

    Article  PubMed  Google Scholar 

  17. Feinsilver SH, Hertz G. Sleep in the elderly. Clin Chest Med. 1993; 14 (3): 405–411.

    PubMed  CAS  Google Scholar 

  18. Hoch CC, Reynolds CF III, Monk TN, et al. Comparison of sleep disordered breathing among healthy elderly in the seventh, eighth, and ninth decades of life. Sleep. 1990; 13 (6): 502–511.

    PubMed  CAS  Google Scholar 

  19. Ancoli-Israel S, Cox T. Are breathing disturbances in elderly equivalent to sleep apnea syndrome. Sleep. 1994; 17 (l): 77–83.

    Google Scholar 

  20. Tousignant P, Cosio MG, Levy RD, et al. Quality adjusted life years added by treatment of obstructive sleep apnea. Sleep. 1994; 17 (l): 52–60.

    Google Scholar 

  21. Fletcher C, Peto R. The natural history of chronic airflow obstruction. Br Med J. 1977; 1: 1645–1648.

    Article  PubMed  CAS  Google Scholar 

  22. Holleman DR, Simel DL, Goldberg JS. Diagnosis of obstructive airways disease from the clinical examination. J Gen Intern Med. 1993; 8: 63–68.

    Article  PubMed  Google Scholar 

  23. Enright PL, Kronmal RA, Higgins MW, et al. Prevalence and correlates of respiratory symptoms and disease in the elderly. Chest. 1994; 106: 827–834.

    Article  PubMed  CAS  Google Scholar 

  24. Anthonisen NR. Prognosis in chronic obstructive pulmonary disease: results from multicenter clinical trials. Rev Respir Dis. 1989; 140: 595–599.

    Google Scholar 

  25. Rimer BK, Orleans CT, Keintz MK, et al. The older smokers: status, challenges and opportunities for intervention. Chest. 1990; 97: 547–553.

    Article  PubMed  CAS  Google Scholar 

  26. Orleans CT, Jepson C, Resch N, et al. Quitting motives and barriers among older smokers. Cancer Suppl. 1994; 74: 2055–2061.

    Article  CAS  Google Scholar 

  27. Higgins MW, Enright PL, Kronmal RA, et al. Smoking and lung function in elderly men and women: the cardiovascular health study. JAMA. 1993; 269: 2741–2748.

    Article  PubMed  CAS  Google Scholar 

  28. Daniels S, Meuleman J. Importance of assessment of me-tered-dose inhaler technique in the elderly. J Am Geriatric Soc. 1994; 42: 82–84.

    CAS  Google Scholar 

  29. Kerstjens HAM, Brand PLP, Hughes MD, et al. A comparison of bronchodilator therapy with or without inhaled corticosteroid therapy for obstructive airways disease. N Engl J Med. 1992; 327: 1413–1419.

    Article  PubMed  CAS  Google Scholar 

  30. O’Driscoll BR, Kalra S, Wilson M. Double-blind trial of steroid tapering in acute asthma. Lancet. 1993; 6 (341): 324–327.

    Article  Google Scholar 

  31. Shannon M. Predictors of major toxicity after the theophyllin overdose. Ann Intern Med. 1993; 119: 1161–1167.

    PubMed  CAS  Google Scholar 

  32. Isada CM, Stollar JK. Chronic bronchitis: role of antibiotics. In: Niederman MS, Sarosi GA, Glassroth J, eds. Respiratory Infections. Philadelphia: WB Saunders; 1994.

    Google Scholar 

  33. Boysen PG, Block AJ, Wynne JW, et al. Nocturnal pulmonary hypertension in patients with chronic obstructive pulmonary disease. Chest. 1979; 76: 536–542.

    Article  PubMed  CAS  Google Scholar 

  34. Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy and hypoxemic chronic obstructive lung disease: a clinical trial. Ann Intern Med. 1980; 93: 391–398.

    Google Scholar 

  35. Swinburn CR, Mould H, Stone TN, et al. Symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease. Am Rev Respir Dis. 1991; 143: 913–915.

    PubMed  CAS  Google Scholar 

  36. Dales RE, Dionne G, Leech JA, Lunau M, Schweitzer I. Preoperative prediction of pulmonary complications following thoracic surgery. Chest. 1993; 104: 155–159.

    Article  PubMed  CAS  Google Scholar 

  37. Zibrak JD, O’Donnell CR. Indications for preoperative pulmonary function testing. Indications for preoperative pulmonary function testing. Clin Chest Med. 1993; 14 (2): 227–236.

    PubMed  CAS  Google Scholar 

  38. Hall JC, Tarala R, Harris J, Tapper J, Christiansen K. Incentive spirometry versus routine chest physiotherapy for prevention of pulmonary complications after abdominal surgery. Lancet. 1991; 337: 953–956.

    Article  PubMed  CAS  Google Scholar 

  39. Wasylak TJ, Abbot FV, English MJM, et al. Reduction of postoperative morbidity following patient controlled morphine. Can J Anaesth. 1990; 37 (7): 726–731.

    Article  PubMed  CAS  Google Scholar 

  40. Egbert AM, Parks LH, Short LM, et al. Randomized trial of postoperative patient-controlled analysis versus intramuscular narcotics in frail elderly men. Arch Intern Med. 1990; 150: 1897–1903.

    Article  PubMed  CAS  Google Scholar 

  41. Thomas DR, Ritchie CS. Preoperative assessment of older adults. J Am Geriatr Soc. 1995; 43: 811–821.

    PubMed  CAS  Google Scholar 

  42. Clarke DE, Goldstein MK, Raffin TA. Ethical dilemmas in the critically ill elderly. Clin Geriatr Med. 1994; 10: 91–101.

    PubMed  CAS  Google Scholar 

  43. Pesau B, Falger S, Berger E, et al. Influence of age on outcome of mechanically ventilated patients in an intensive care unit. Crit Care Med. 1992; 20: 489–492.

    Article  PubMed  CAS  Google Scholar 

  44. Heuser MD, Case LD, Ettinger WH. Mortality in intensive care patients with respiratory disease, is age important? Arch Intern Med. 1992; 152: 1683–1688.

    Article  PubMed  CAS  Google Scholar 

  45. Krieger BP. Respiratory failure in the elderly. Clin Geriatr Med 1994; 10: 103–119.

    PubMed  CAS  Google Scholar 

  46. Hanson LC, Danic M. Use of life sustaining care for the elderly. J Am Geriatr Soc. 1991; 39: 772–777.

    PubMed  CAS  Google Scholar 

  47. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: A severity of illness disease classification system. Crit Care Med. 1985; 13: 818–829.

    Article  PubMed  CAS  Google Scholar 

  48. Cohen IL, Lombrinos J, Fein A. Mechanical ventilation for the elderly patient in intensive care: incremental charges and benefits. JAMA. 1993; 269: 1025–1029.

    Article  PubMed  CAS  Google Scholar 

  49. Pearlman RA. Variability in physician estimates of survival for acute respiratory failure in chronic obstructive pulmonary disease. Chest. 1987; 91: 515–521.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. James R. Webster Jr.
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  2. Thomas Cain
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Editor information

Editors and Affiliations

  1. The Henry L. Schwartz Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, 10029-6574, New York, NY, USA

    Christine K. Cassel M.D. (Professor and Chairman) & Diane E. Meier M.D. (Associate Professor) (Professor and Chairman) &  (Associate Professor)

  2. Center for Study of Aging and Geriatric Research Education and Clinical Center, Duke University Medical Center, 27710, Durham, NC, USA

    Harvey J. Cohen M.D. (Director) (Director)

  3. University of Washington Medical Center, 98195, Seattle, WA, USA

    Eric B. Larson M.D., M.P.H. (Medical Director) (Medical Director)

  4. Gerontology Division, Harvard Medical School, Brigham and Women’s Hospital, 02115, Boston, MA, USA

    Neil M. Resnick M.D. (Chief) (Chief)

  5. Geriatric Research Education and Clinical Center, Sepulveda VA Medical Center, 91343, Sepulveda, CA, USA

    Laurence Z. Rubenstein M.D., M.P.H. (Director) (Director)

  6. Department of Medicine, University of Chicago, 60637, Chicago, IL, USA

    Leif B. Sorensen M.D. (Professor and Vice Chairman) (Professor and Vice Chairman)

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© 1997 Springer Science+Business Media New York

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Webster, J.R., Cain, T. (1997). Pulmonary Disease. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_43

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  • DOI: https://doi.org/10.1007/978-1-4757-2705-0_43

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2707-4

  • Online ISBN: 978-1-4757-2705-0

  • eBook Packages: Springer Book Archive

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