Emphysema and the Lungs of the Aged: A Clinical Study

Preliminary Report

Preliminary findings in a clinical study of emphysema in aged men and women have yielded substantial support of the validity of our concepts of "senile lung" versus "senile emphysema." Aging is associated with changes which result in the senile lung. In our study this change became clinically demonstrable particularly after age 80 and predominantly n women. We found it rarely recognizable before that. However, not all persons show this change, even at this advanced age. In the aged who have led a life of vigorous activity, senile lung changes, particularly in men, appear to be delayed or absent. "Atrophy through disuse" probably plays a role in the changes of the "senile lung."

The term "senile emphysema" appears to us to be a misnomer. The "senile lung" does not manifest itself clinically as emphysema, nor is the latter a common disease among the aged. Clinical emphysema presents the same features in the aged as in the young. In aged emphysematous people the clinical signs and symptoms of obstructive breathing are present and the thorax is overdistended. In the truly senile state, the chest and lungs show loss of structure and contraction in volume, but their functions appear quite suffcient for these aged people with their reduced activities. In some instances "senile lung" changes may predispose to a late and rapid onset of emphysema under such pathologic conditions as congestive failure or bronchopulmonary infections, which tend to increase the functional burden upon the heart and lungs.