Table of Contents

Aging and Lung Disease; Preface; Contents; Contributors; Part I:Physiologic Changes; Chapter 1: Physiologic Changes in the Aging Lung; Case Presentation; Respiratory Physiology; Gas Exchange at Rest; Gas Exchange During Exercise; Normal Aging; Central Respiratory Drive; Respiratory Muscles; Respiratory Mechanics; Lung Perfusion; Breathing Reserve (Exercise); Clinical Implications; Conclusion; References; Chapter 2: Allergy and Immunology of the Aging Lung; Introduction; Overview of Innate immunity; Overview of Adaptive Immunity; Innate Immunity of the Lung; Adaptive Immunity of the Lung Immunity of the Aging LungAllergy of the Aging Lung; Conclusion; References; Chapter 3: Physiologic Changes in Sleep with Aging; Introduction; Sleep-Wake Cycle; Sleep Duration; Sleep Staging; Sleep Architecture; Normal Respiration During Sleep; Ventilation, Respiratory Patterns and Apnea; Gas Exchange; Airway Collapsibility; Summary; References; Part II: Lung Diseases in Older Patients: Epidemiology, Presentation, Diagnosis, Treatment; Chapter 4: Chronic Obstructive Pulmonary Disease in Older Patients; Epidemiology; "Normal" Aging-Related Changes; Lung Function; Immune System; Pathogenesis Clinical SymptomsNonpulmonary Symptoms and Comorbidities; Cardiovascular Disease; Cachexia; Osteopenia and Osteoporosis; Swallowing Dysfunction; Cognitive Dysfunction; Depression; Diagnosis; Classification of Severity; COPD Management; Smoking Cessation; Immunization; Beta-agonist Bronchodilators; Anticholinergic Bronchodilators; Corticosteroids; Inhaled Corticosteroids; Systemic Corticosteroids; Antibiotics; Phosphodiesterase Inhibitor; N -Acetylcysteine; Pulmonary Rehabilitation; Long-Term Oxygen Therapy; Lung Volume Reduction; Surgical; Endobronchial LVR; Lung Transplantation Noninvasive VentilationPalliative Care/End of Life; Conclusion; References; Chapter 5: Lung Cancer in Older Patients; Introduction; Definitions and Barriers to Treatment; Non-small-Cell Lung Cancer; Early Stage NSCLC: American Joint Committee on Cancer (AJCC) 7th Edition: T1-3, N0/1, M0; Stage I-IIIA (Table 5.1 and Fig. 5.1) [ 4 ]; Surgery; Chemotherapy; Locally Advanced NSCLC (AJCC 7th Edition: T1/2/3/4, N2/3, M0; Stage IIIA/B) [ 4 ]; Metastatic NSCLC (AJCC 7th Edition: Tany, Nany, M1; Stage IV) [ 4 ]; Single-Agent Chemotherapy; Doublet Chemotherapy; Salvage Therapy Conclusions: Chemotherapy for Advanced NSCLCSmall Cell Lung Cancer; Limited Stage SCLC; Extensive Stage SCLC; Prophylactic Cranial Irradiation; Conclusions; References; Chapter 6: Pulmonary Hypertension in Older Patients; Introduction; Classification; Pulmonary Arterial Hypertension; Pulmonary Hypertension Associated with Left Heart Disease; Pulmonary Hypertension Associated with Lung Disease; Pulmonary Hypertension Associated with Chronic Thromboembolic Disease; Assessment; Treatment; Supplemental Oxygen, Diuretics, Digoxin, Anticoagulation; Calcium Channel Blockers; Targeted Therapies Phosphodiesterase Inhibitors People age 65 and older are the fastest growing segment of the U.S. population.  In the 2010 census 16% of the population, 50 million people, were age 65 and older.  That number is projected to increase to 66 million by the year 2050.  Life expectancy has also increased, with recent CDC reports indicating life expectancy at 77.9 years.  Age-adjusted death rates have decreased significantly with the largest changes occurring in older patients.  Despite these trends, the 10 leading causes of death include several pulmonary etiologies including lung cancer, chronic respiratory diseases, influenza and pneumonia. Aging and Lung Disease: A Clinical Guide  is devoted to understanding the impact of respiratory diseases in older patients.  It includes reviews of physiology of the aging lung, allergy and immunology of the aging, as well as sleep changes over the life cycle.  There are also comprehensive reviews on specific disease topics including chronic obstructive lung disease, lung cancer, atypical mycobacteria, interstitial lung disease, pulmonary hypertension, pulmonary embolism, obstructive sleep apnea, and sleep disorders in older patients.  Two chapters focus on unique issues in older patients; HIV and lung transplant. Included also are important chapters on assessing functional and cognitive status and end-of-life issues in older patients with lung disease.  In addition to outlining the current state of knowledge, each chapter focuses on special considerations when caring for older patients.  Of particular interest to pulmonologists, internists, and gerontologists, other readers, such as pulmonary and geriatric nurse practitioners, as well as clinical researchers interested in both pulmonary and aging issues, will find Aging and Lung Disease: A Clinical Guide to be a vital resource for improving their care of older patients with lung disorders.