Changes in Lung in Old age

[phd89]

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What are lung volume changes noted in old age? ie changes in TV,RV,FEV1/FVC or etc
Does it look like a restrictive pattern?
Are there any changes in elastic recoil/ compliance

 

[Phloston]

I'm almost certain old age = restrictive. Therefore, compliance decreases and elasticity is normal or increases.

I had encountered a practice question at some point that gave an FEV1/FVC curve and asked to identify the pathology. The answer was asthma (the only obstructive one). The four other answer choices were something like interstitial fibrosis, silicosis, scoliosis, old age.

To that effect, I've also seen a practice question that had given a vignette of dyspnoea in a patient and severe scoliosis was the answer (implying restrictive potential).

 

[islandCrazy]

I'm almost certain old age = restrictive. Therefore, compliance decreases and elasticity is normal or increases.

I had encountered a practice question at some point that gave an FEV1/FVC curve and asked to identify the pathology. The answer was asthma (the only obstructive one). The four other answer choices were something like interstitial fibrosis, silicosis, scoliosis, old age.

To that effect, I've also seen a practice question that had given a vignette of dyspnoea in a patient and severe scoliosis was the answer (implying restrictive potential).

Could you explain this more as I thought in elderly the compliance increase while the elasticity decreases.

 

[Phloston]

Could you explain this more as I thought in elderly the compliance increase while the elasticity decreases.

If that's the case, then perhaps you could explain it to me. As far as I'm aware at the moment, just based on that practice question I had done, old age should be a restricted pathology, which means decreased compliance and increased elasticity. I'd definitely be happy to hear your input or see sources that say either or.

 

[islandCrazy]

I heard it form a Kaplan Video: Increase compliance because there is a decrease elastic recoil as you age. Its also viewed equivalent to an emphysema, because emphysema is due to a lost of elastin tissue, while aging is due to a rearrangement of elastin. So the FEV1/FVC ratio would decrease not increase.

Here an review article that states the lung compliance increase with aging- http://www.anesthesiaweb.org/images/lung-function/Wahba-1983.pdf

 

[Phloston]

Interesting. That's good to know, thanks.

However, I took a look at the article, and it says in the first paragraph on the right-hand side of the first page that progressive stiffening of the chest wall prevents an increased FRC. Therefore, there's increased compliance and decreased elasticity without the expansion of lung volume.

So my guess is the spirometry curves would resemble an obstructive pathology, except you'd have to be vigilant of the lung volume axis; in asthma/COPD, it would be increased (~7L), but in old age, it would be normal (~5L).

 

[Phloston]

Between the two of you, I'm really glad I learned something from this thread.