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Pulmonary Health and Healthy Aging

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Healthy Aging

Abstract

Lung function declines with age. Decreased elastic recoil of the lungs, impaired mucociliary clearance, and skeletal muscle weakness all contribute to decreased lung function and compromised airway function and clearance. As a result of these changes, cough and dyspnea become increasingly common in older adults. Between these changes to the airway and scarring processes in the lung from conditions like pneumonia, chronic lung diseases increase with age. Importantly, multimorbidity from cardiac, gastrointestinal, and nasopharyngeal causes is more prevalent with age and complicates elucidating the exact cause of respiratory symptoms. While many of the changes are inevitable with time, healthy pulmonary aging depends on physical activity, proper diet and weight management, avoidance of smoking and environmental exposures, and guideline-based lung cancer screening. This chapter will discuss the pathophysiology of lung diseases in older adults while also considering strategies for optimizing lung health with age.

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References

  1. Ware JH, et al. Longitudinal and cross-sectional estimates of pulmonary function decline in never-smoking adults. Am J Epidemiol. 1990;132(4):685–700.

    Article  CAS  PubMed  Google Scholar 

  2. van Oostrom SH, et al. Aging-related trajectories of lung function in the general population-the Doetinchem cohort study. PLoS One. 2018;13(5):e0197250.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  3. Mirabelli MC, et al. Lung function decline over 25 years of follow-up among black and white adults in the ARIC study cohort. Respir Med. 2016;113:57–64.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mays PK, Bishop JE, Laurent GJ. Age-related changes in the proportion of types I and III collagen. Mech Ageing Dev. 1988;45(3):203–12.

    Article  CAS  PubMed  Google Scholar 

  5. Niewoehner DE, Kleinerman J. Morphologic basis of pulmonary resistance in the human lung and effects of aging. J Appl Physiol. 1974;36(4):412–8.

    Article  CAS  PubMed  Google Scholar 

  6. Gillooly M, Lamb D. Airspace size in lungs of lifelong non-smokers: effect of age and sex. Thorax. 1993;48(1):39–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Mittman C, Edelman NH, Norris AH, et al. Relationship between chest wall and pulmonary compliance with age. J Appl Physiol. 1965;20(6):1211–6.

    Article  Google Scholar 

  8. Shephard R. Aging, respiratory function, and exercise. J Aging Phys Act. 1993;1(1):59–83.

    Article  Google Scholar 

  9. Wahba WM. Influence of aging on lung function – clinical significance of changes from age twenty. Anesth Analg. 1983;62(8):764–76.

    Article  CAS  PubMed  Google Scholar 

  10. Butler C 2nd, Kleinerman J. Capillary density: alveolar diameter, a morphometric approach to ventilation and perfusion. Am Rev Respir Dis. 1970;102(6):886–94.

    PubMed  Google Scholar 

  11. Chan ED, Welsh CH. Geriatric respiratory medicine. Chest. 1998;114(6):1704–33.

    Article  CAS  PubMed  Google Scholar 

  12. Lowery EM, et al. The aging lung. Clin Interv Aging. 2013;8:1489–96.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Roman MA, Rossiter HB, Casaburi R. Exercise, ageing and the lung. Eur Respir J. 2016;48(5):1471–86.

    Article  PubMed  Google Scholar 

  14. Polkey MI, et al. The contractile properties of the elderly human diaphragm. Am J Respir Crit Care Med. 1997;155(5):1560–4.

    Article  CAS  PubMed  Google Scholar 

  15. Tolep K, et al. Comparison of diaphragm strength between healthy adult elderly and young men. Am J Respir Crit Care Med. 1995;152(2):677–82.

    Article  CAS  PubMed  Google Scholar 

  16. Bellia V, et al. Quality control of spirometry in the elderly. The SA.R.A. study. SAlute respiration nell’Anziano = respiratory health in the elderly. Am J Respir Crit Care Med. 2000;161(4 Pt 1):1094–100.

    Article  CAS  PubMed  Google Scholar 

  17. Janssens JP. Aging of the respiratory system: impact on pulmonary function tests and adaptation to exertion. Clin Chest Med. 2005;26(3):469–84, vi-vii.

    Article  PubMed  Google Scholar 

  18. Vaz Fragoso CA, Gill TM. Respiratory impairment and the aging lung: a novel paradigm for assessing pulmonary function. J Gerontol A Biol Sci Med Sci. 2012;67(3):264–75.

    Article  PubMed  Google Scholar 

  19. Martinez CH, et al. Age and small airway imaging abnormalities in subjects with and without airflow obstruction in SPIROMICS. Am J Respir Crit Care Med. 2017;195(4):464–72.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Quanjer PH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40(6):1324–43.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Enright PL, et al. Respiratory muscle strength in the elderly. Correlates and reference values. Cardiovascular Health Study Research Group. Am J Respir Crit Care Med. 1994;149(2 Pt 1):430–8.

    Article  CAS  PubMed  Google Scholar 

  22. Guenard H, Marthan R. Pulmonary gas exchange in elderly subjects. Eur Respir J. 1996;9(12):2573–7.

    Article  CAS  PubMed  Google Scholar 

  23. Astrand I, et al. Reduction in maximal oxygen uptake with age. J Appl Physiol. 1973;35(5):649–54.

    Article  CAS  PubMed  Google Scholar 

  24. Posner JD, et al. Ventilatory threshold: measurement and variation with age. J Appl Physiol. 1985.), 1987;63(4):1519–25.

    Article  Google Scholar 

  25. Hing E, Okeyode T, Rui P. National Ambulatory Medical Care Survey – Community Health Centers: 2012 State and National Summary Tables.

    Google Scholar 

  26. Pavord ID, Chung KF. Management of chronic cough. Lancet. 2008;371(9621):1375–84.

    Article  PubMed  Google Scholar 

  27. Newnham DM, Hamilton SJ. Sensitivity of the cough reflex in young and elderly subjects. Age Ageing. 1997;26(3):185–8.

    Article  CAS  PubMed  Google Scholar 

  28. Ebihara S, Ebihara T, Kohzuki M. Effect of aging on cough and swallowing reflexes: implications for preventing aspiration pneumonia. Lung. 2012;190(1):29–33.

    Article  PubMed  Google Scholar 

  29. Pontoppidan H, Beecher HK. Progressive loss of protective reflexes in the airway with the advance of age. JAMA. 1960;174:2209–13.

    Article  CAS  PubMed  Google Scholar 

  30. Parshall MB, et al. An official American Thoracic Society statement: update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012;185(4):435–52.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Huijnen B, et al. Dyspnea in elderly family practice patients. Occurrence, severity, quality of life and mortality over an 8-year period. Fam Pract. 2006;23(1):34–9.

    Article  PubMed  Google Scholar 

  32. Mahler DA. Evaluation of dyspnea in the elderly. Clin Geriatr Med. 2017;33(4):503–21.

    Article  PubMed  Google Scholar 

  33. Tessier JF, et al. Dyspnea and 8-year mortality among elderly men and women: the PAQUID cohort study. Eur J Epidemiol. 2001;17(3):223–9.

    Article  CAS  PubMed  Google Scholar 

  34. Wirth R, et al. Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016;11:189–208.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kikawada M, Iwamoto T, Takasaki M. Aspiration and infection in the elderly: epidemiology, diagnosis and management. Drugs Aging. 2005;22(2):115–30.

    Article  PubMed  Google Scholar 

  36. Lee A, et al. Characteristics and outcomes of patients hospitalized following pulmonary aspiration. Chest. 2014;146(4):899–907.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Hollaar V, et al. Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi method. BMC Geriatr. 2016;16:60.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Manabe T, et al. Risk factors for aspiration pneumonia in older adults. PLoS One. 2015;10(10):e0140060.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. in Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities. 2016: Hyattsville (MD).

    Google Scholar 

  40. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):e442.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Terzikhan N, et al. Prevalence and incidence of COPD in smokers and non-smokers: the Rotterdam study. Eur J Epidemiol. 2016;31(8):785–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Tudorache E, et al. Aging and extrapulmonary effects of chronic obstructive pulmonary disease. Clin Interv Aging. 2017;12:1281–7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Marengoni A, et al. The relationship between COPD and frailty: a systematic review and meta-analysis of observational studies. Chest. 2018;154(1):21–40.

    Article  PubMed  Google Scholar 

  44. Kunisaki KM, et al. Exacerbations of chronic obstructive pulmonary disease and cardiac events: a cohort analysis. Am J Respir Crit Care Med. 2018;198(1):51–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Vogelmeier CF, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report: GOLD executive summary. Eur Respir J. 2017;49(3):1700214.

    Article  PubMed  Google Scholar 

  46. Melani AS, et al. Inhaler mishandling is very common in patients with chronic airflow obstruction and long-term home nebuliser use. Respir Med. 2012;106(5):668–76.

    Article  PubMed  Google Scholar 

  47. Akgun KM, Crothers K, Pisani M. Epidemiology and management of common pulmonary diseases in older persons. J Gerontol A Biol Sci Med Sci. 2012;67(3):276–91.

    Article  PubMed  Google Scholar 

  48. Stupka E, deShazo R. Asthma in seniors: Part 1. Evidence for underdiagnosis, undertreatment, and increasing morbidity and mortality. Am J Med. 2009;122(1):6–11.

    Article  PubMed  Google Scholar 

  49. Cazzola M, et al. Cardiovascular disease in asthma and COPD: a population-based retrospective cross-sectional study. Respir Med. 2012;106(2):249–56.

    Article  PubMed  Google Scholar 

  50. de Roos EW, et al. Asthma and its comorbidities in middle-aged and older adults; the Rotterdam study. Respir Med. 2018;139:6–12.

    Article  PubMed  Google Scholar 

  51. Skloot GS, et al. An official American Thoracic Society workshop report: evaluation and Management of Asthma in the elderly. Ann Am Thorac Soc. 2016;13(11):2064–77.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Zein JG, et al. Asthma is more severe in older adults. PLoS One. 2015;10(7):e0133490.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  53. Patterson KC, et al. Interstitial lung disease in the elderly. Chest. 2017;151(4):838–44.

    Article  PubMed  Google Scholar 

  54. Raghu G, et al. Idiopathic pulmonary fibrosis in US Medicare beneficiaries aged 65 years and older: incidence, prevalence, and survival, 2001-11. Lancet Respir Med. 2014;2(7):566–72.

    Article  PubMed  Google Scholar 

  55. Jura M, Kozak LP. Obesity and related consequences to ageing. Age (Dordr). 2016;38(1):23.

    Article  CAS  Google Scholar 

  56. Jensen D, Ofir D, O’Donnell DE. Effects of pregnancy, obesity and aging on the intensity of perceived breathlessness during exercise in healthy humans. Respir Physiol Neurobiol. 2009;167(1):87–100.

    Article  PubMed  Google Scholar 

  57. Luce JM. Respiratory complications of obesity. Chest. 1980;78(4):626–31.

    Article  CAS  PubMed  Google Scholar 

  58. McDonald VM, et al. Should we treat obesity in COPD? The effects of diet and resistance exercise training. Respirology. 2016;21(5):875–82.

    Article  PubMed  Google Scholar 

  59. Adeniyi FB, Young T. Weight loss interventions for chronic asthma. Cochrane Database Syst Rev. 2012;7:CD009339.

    Google Scholar 

  60. Siegel R, et al. Cancer statistics, 2014. CA Cancer J Clin. 2014;64(1):9–29.

    Article  PubMed  Google Scholar 

  61. Stewart GC, et al. INTERMACS (Interagency Registry for mechanically assisted circulatory support) profiling identifies ambulatory patients at high risk on medical therapy after hospitalizations for heart failure. Circ Heart Fail. 2016;9(11):e003032.

    Article  PubMed  Google Scholar 

  62. Church TR, National Lung C. Screening trial executive, chest radiography as the comparison for spiral CT in the National Lung Screening Trial. Acad Radiol. 2003;10(6):713–5.

    Article  PubMed  Google Scholar 

  63. Doria-Rose VP, et al. Use of lung cancer screening tests in the United States: results from the 2010 National Health Interview Survey. Cancer Epidemiol Biomark Prev. 2012;21(7):1049–59.

    Article  Google Scholar 

  64. Oken MM, et al. Screening by chest radiograph and lung cancer mortality: the prostate, lung, colorectal, and ovarian (PLCO) randomized trial. JAMA. 2011;306(17):1865–73.

    Article  CAS  PubMed  Google Scholar 

  65. Detterbeck FC, et al. Screening for lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e78S–92S.

    Article  PubMed  PubMed Central  Google Scholar 

  66. National Lung Screening Trial Research, T, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.

    Article  Google Scholar 

  67. Lichvar AB, et al. Evaluation of direct oral anticoagulation therapy in heart and lung transplant recipients. Prog Transplant. 2016;26(3):263–9.

    Article  PubMed  Google Scholar 

  68. Wender R, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013;63(2):107–17.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Jamal A, et al. Current cigarette smoking among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;67(2):53–9.

    Article  PubMed  PubMed Central  Google Scholar 

  70. CDC, Smoking and health in the Americas: a 1992 report of the Surgeon General, in collaboration with the Pan American Health Organization, P.H.S. Department of Health and Human Services, Editor. 1992: Atlanta: US.

    Google Scholar 

  71. Health, N.C.f.C.D.P.a.H.P.U.O.o.S.a., The health consequences of smoking—50 years of progress: a report of the Surgeon General, C.f.D.C.a.P. (US), Editor. 2014: Atlanta (GA).

    Google Scholar 

  72. Gellert C, Schottker B, Brenner H. Smoking and all-cause mortality in older people: systematic review and meta-analysis. Arch Intern Med. 2012;172(11):837–44.

    Article  PubMed  Google Scholar 

  73. Strine TW, et al. Health-related quality of life and health risk behaviors among smokers. Am J Prev Med. 2005;28(2):182–7.

    Article  PubMed  Google Scholar 

  74. Ostbye T, Taylor DH, Jung SH. A longitudinal study of the effects of tobacco smoking and other modifiable risk factors on ill health in middle-aged and old Americans: results from the health and retirement study and asset and health dynamics among the oldest old survey. Prev Med. 2002;34(3):334–45.

    Article  PubMed  Google Scholar 

  75. Arday DR, et al. Smoking and functional status among Medicare managed care enrollees. Am J Prev Med. 2003;24(3):234–41.

    Article  PubMed  Google Scholar 

  76. Shadel WG, et al. Clinician advice to quit smoking among seniors. Prev Med. 2015;70:83–9.

    Article  PubMed  Google Scholar 

  77. Scholz J, et al. Effects of aging on the effectiveness of smoking cessation medication. Oncotarget. 2016;7(21):30032–6.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Burns DM. Cigarette smoking among the elderly: disease consequences and the benefits of cessation. Am J Health Promot. 2000;14(6):357–61.

    Article  CAS  PubMed  Google Scholar 

  79. Winpenny E, et al. Advice to quit smoking and ratings of health care among medicare beneficiaries aged 65. Health Serv Res. 2017;52(1):207–19.

    Article  PubMed  Google Scholar 

  80. Huang Y, Lewis S, Britton J. Use of varenicline for smoking cessation treatment in UK primary care: an association rule mining analysis. BMC Public Health. 2014;14:1024.

    Article  PubMed  PubMed Central  Google Scholar 

  81. Cawkwell PB, Blaum C, Sherman SE. Pharmacological smoking cessation therapies in older adults: a review of the evidence. Drugs Aging. 2015;32(6):443–51.

    Article  PubMed  Google Scholar 

  82. Skinner A, et al. Access to subsidized smoking cessation medications by Australian smokers aged 45 years and older: a population-based cohort study. Nicotine Tob Res. 2017;19(3):342–50.

    PubMed  Google Scholar 

  83. Kasza KA, et al. Use of stop-smoking medications in the United States before and after the introduction of varenicline. Addiction. 2015;110(2):346–55.

    Article  PubMed  Google Scholar 

  84. Thompson WW, et al. Influenza-associated hospitalizations in the United States. JAMA. 2004;292(11):1333–40.

    Article  CAS  PubMed  Google Scholar 

  85. Schuchat A, et al. Progress in vaccine-preventable and respiratory infectious diseases-first 10 years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015. Emerg Infect Dis. 2018;24(7):1178–87.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Williams WW, et al. Surveillance of vaccination coverage among adult populations – United States, 2014. MMWR Surveill Summ. 2016;65(1):1–36.

    Article  PubMed  Google Scholar 

  87. Vu T, et al. A meta-analysis of effectiveness of influenza vaccine in persons aged 65 years and over living in the community. Vaccine. 2002;20(13–14):1831–6.

    Article  PubMed  Google Scholar 

  88. Govaert TM, et al. The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial. JAMA. 1994;272(21):1661–5.

    Article  CAS  PubMed  Google Scholar 

  89. Nichol KL, Mac Donald R, Hauge M. Factors associated with influenza and pneumococcal vaccination behavior among high-risk adults. J Gen Intern Med. 1996;11(11):673–7.

    Article  CAS  PubMed  Google Scholar 

  90. Nied RJ, Franklin B. Promoting and prescribing exercise for the elderly. Am Fam Physician. 2002;65(3):419–26.

    PubMed  Google Scholar 

  91. McClaran SR, et al. Longitudinal effects of aging on lung function at rest and exercise in healthy active fit elderly adults. J Appl Physiol (1985). 1995;78(5):1957–68.

    Article  CAS  Google Scholar 

  92. Coffman KE, et al. The effect of aging and cardiorespiratory fitness on the lung diffusing capacity response to exercise in healthy humans. J Appl Physiol (1985). 2017;122(6):1425–34.

    Article  CAS  Google Scholar 

  93. Mangen MJ, et al. The impact of community-acquired pneumonia on the health-related quality-of-life in elderly. BMC Infect Dis. 2017;17(1):208.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Kikuchi R, et al. High incidence of silent aspiration in elderly patients with community-acquired pneumonia. Am J Respir Crit Care Med. 1994;150(1):251–3.

    Article  CAS  PubMed  Google Scholar 

  95. Nakagawa T, et al. High incidence of pneumonia in elderly patients with basal ganglia infarction. Arch Intern Med. 1997;157(3):321–4.

    Article  CAS  PubMed  Google Scholar 

  96. Nakajoh K, et al. Relation between incidence of pneumonia and protective reflexes in post-stroke patients with oral or tube feeding. J Intern Med. 2000;247(1):39–42.

    Article  CAS  PubMed  Google Scholar 

  97. Yamaya M, et al. Interventions to prevent pneumonia among older adults. J Am Geriatr Soc. 2001;49(1):85–90.

    Article  CAS  PubMed  Google Scholar 

  98. Katsumata U, et al. Aging effects on cough reflex. Chest. 1995;107(1):290–1.

    Article  CAS  PubMed  Google Scholar 

  99. Kobayashi H, Sekizawa K, Sasaki H. Aging effects on swallowing reflex. Chest. 1997;111(5):1466.

    Article  CAS  PubMed  Google Scholar 

  100. Dicpinigaitis PV. Angiotensin-converting enzyme inhibitor-induced cough: ACCP evidence-based clinical practice guidelines. Chest. 2006;129(1 Suppl):169S–73S.

    Article  CAS  PubMed  Google Scholar 

  101. Johanson WG Jr, et al. Nosocomial respiratory infections with gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med. 1972;77(5):701–6.

    Article  PubMed  Google Scholar 

  102. Yoneyama T, et al. Oral care reduces pneumonia in older patients in nursing homes. J Am Geriatr Soc. 2002;50(3):430–3.

    Article  PubMed  Google Scholar 

  103. Meguro K, et al. Prevention of respiratory infections in elderly bed-bound nursing home patients. Tohoku J Exp Med. 1992;167(2):135–42.

    Article  CAS  PubMed  Google Scholar 

  104. D’Amato G, et al. Climate change and air pollution: effects on respiratory allergy. Allergy Asthma Immunol Res. 2016;8(5):391–5.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  105. Paulin L, Hansel N. Particulate air pollution and impaired lung function. F1000Res. 2016;5:201.

    Article  Google Scholar 

  106. Kelly FJ, Dunster C, Mudway I. Air pollution and the elderly: oxidant/antioxidant issues worth consideration. Eur Respir J Suppl. 2003;40:70s–5s.

    Article  CAS  PubMed  Google Scholar 

  107. Simoni M, et al. Adverse effects of outdoor pollution in the elderly. J Thorac Dis. 2015;7(1):34–45.

    PubMed  PubMed Central  Google Scholar 

  108. Lepeule J, et al. Long-term effects of traffic particles on lung function decline in the elderly. Am J Respir Crit Care Med. 2014;190(5):542–8.

    Article  PubMed  PubMed Central  Google Scholar 

  109. Sinharay R, et al. Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study. Lancet. 2018;391(10118):339–49.

    Article  PubMed  PubMed Central  Google Scholar 

  110. Butland BK, Fehily AM, Elwood PC. Diet, lung function, and lung function decline in a cohort of 2512 middle aged men. Thorax. 2000;55(2):102–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  111. Garcia-Larsen V, et al. Dietary antioxidants and 10-year lung function decline in adults from the ECRHS survey. Eur Respir J. 2017;50(6):1602286.

    Article  PubMed  PubMed Central  Google Scholar 

  112. Grievink L, et al. Dietary intake of antioxidant (pro)-vitamins, respiratory symptoms and pulmonary function: the MORGEN study. Thorax. 1998;53(3):166–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Clark, B.J., Roeder, N., Akgün, K.M. (2019). Pulmonary Health and Healthy Aging. In: Coll, P. (eds) Healthy Aging. Springer, Cham. https://doi.org/10.1007/978-3-030-06200-2_8

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