MODULE SUPPLEMENT: PULMONARY SYSTEM
Clinical Implications

What are the clinical implications of the changes that occur in the respiratory system?

Although the respiratory system of healthy older adults functions quite well into advanced old age, especially at rest, changes do increase their vulnerability. The older adult is at increased risk for respiratory fatigue because of decreased muscle strength and increased work of breathing; they are at increased risk for aspiration pneumonia because of a diminished cough reflex; and they are at increased risk for delayed warning of altered respiratory function because of diminished responsiveness to hypoxia and hypercapnia. Any clinical situation that compromises adequate ventilation increases these risks--for example, bedrest and abdominal surgery or obesity. The elderly have a 5-10 fold increased risk of pneumonia as compared to younger adults and are much more likely to die from this disease than their younger counterparts. It is essential that pulmonary function be monitored in older adults and that preventive strategies, such as smoking cessation, exercise, and vaccinations be used liberally.