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Lung Aging: How It Affects Respiratory Function World Lung Day

Pembicara: Dr. Bhagwan Mantri

Consultant Pulmonologist and Critical care specialist, Moolchand Hospital, Delhi

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Keterangan

As individuals age, lung aging is a natural process that can gradually impact respiratory function. This aging process involves structural changes in the lungs, such as decreased elasticity of lung tissues and a reduction in the number of functional alveoli. These changes can lead to decreased lung capacity, reduced ability to efficiently exchange oxygen and carbon dioxide, and a decline in overall respiratory strength. Consequently, older adults may experience increased breathlessness, reduced tolerance for physical exertion, and an elevated risk of respiratory conditions like chronic obstructive pulmonary disease (COPD) and pneumonia. To mitigate these effects, maintaining a healthy lifestyle, including regular exercise and avoiding smoking, becomes crucial in preserving lung function and overall respiratory health as one ages.

Ringkasan

  • With age, the respiratory system undergoes anatomical, physiological, and immunological changes, beginning in infancy and continuing throughout life. Lung function, including spirometry, diffusion, and total lung capacity, improves until around 20 years of age and remains steady until 35. However, after that, FEV1 decreases approximately 27 ml per year, which is significant. FVC also decreases, typically between 14 to 30 ml per year, depending on exercise and lifestyle.
  • Lung volume decreases with age, but total lung capacity (TLC) remains unchanged when corrected for age and height. Functional residual capacity (FRC), the volume of air remaining in the lungs after forceful expiration, increases, reducing vital capacity. Diffusion capacity also declines, signifying reduced oxygen transfer within the lungs.
  • Respiratory system mechanics, encompassing the lungs, diaphragm, and thoracic cage, are crucial for effective breathing. Lung compliance remains constant with age. The chest wall undergoes structural changes that reduce its compliance. This leads to an increase in residual volume and impaired lung emptying.
  • Senile hyperinflation, resembling COPD, can occur due to degeneration of elastic fibers around the alveoli and reduction in supporting tissue, causing premature airway closure and air trapping. Diaphragm strength, measured by maximum inspiratory pressure (MIP), decreases after 65 years, affecting ventilation and coughing ability.
  • Immunological changes occur with aging. Bronchoalveolar lavage samples show an increase in neutrophils compared to macrophages. Immunoglobulin levels, particularly IgA and IgM, rise. The CD4/CD8 lymphocyte ratio decreases, indicating reduced immune capacity. Hypoxia and hypercapnia response diminishes, with reductions of 50% and 40%, respectively. Bronchial hyperresponsiveness and beta-adrenergic receptor dysfunction also occur, diminishing the effectiveness of bronchodilators.
  • Maintaining lung health involves influenza and pneumonia vaccines and regular respiratory exercises to minimize infection. The lung is not only a breathing tool but a critical part of the body's immune and mechanical system.

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