9.1-Respiratory Diseases

Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease (COPD) is a group of diseases characterized by chronic air flow obstruction in the lungs.  People who suffer from COPD experience difficulty breathing, wheezing, and coughing.  Thy symptoms increase rapidly in those over 50 years of age and most frequent in men.   The most common contributing factor is cigarette smoke, but there is a possible genetic predisposition.

Emphysema is one of the diseases which causes COPD.  Emphysema is characterized by the accumulation of excessive air in the lungs as they lose their ability to ventilate properly.  Chronic irritation of the bronchial tree damages the cilia of the airway while other cells become inflamed and over produce mucus.  This hinders airflow and traps air in the alveoli, which eventually become damaged.  Emphysema places an extra load on the heart as it attempts to pump more blood to the lungs in an effort to compensate for the deficiency of oxygen in the blood leaving the lungs.  It develops gradually and is therefore much more prevalent in older persons.

Chronic bronchitis is another of the diseases which causes COPD.  Chronic bronchitis is characterized by the chronic inflammation of the bronchial tree caused by long-term exposure to environmental irritants or a bacterial infection.  Like in emphysema the chronic inflammation causes the over production of mucus.  As the mucus secretions accumulate within the bronchi, they are removed by coughing, which can become persistent and irritating.

Pneumonia

Pneumonia is an inflammation of the lower airways of the lung in which the alveoli become filled.  This causes the affected portion of the lung to become less spongy and restricts air from reaching the alveoli.  The inflammation may be caused by several different viruses or bacteria.  While these infections can affect people of all ages, they are more frequent in those over 65 whose are less able to fight off the infections.

Tuberculosis

Thanks to the development of antibiotics the incidences of tuberculosis has declined greatly.  Prior to the development of antibiotics tuberculosis was very common bacterial disease.  As many of today’s elderly people were alive during the time period when tuberculosis was prevalent they may have been exposed to this bacteria.  Due to the behavior of this bacteria it is possible that an elderly person inhaled this bacteria years prior and the bacteria was controlled by the immune system.  The bacteria is able to survive for years within tubercles of the lungs.  Due to the weakened immune systems of the elderly the bacteria is able to reinfect the lungs.  While tuberculosis can now be treated with a six to nine month treatment of drug therapy the lungs may be permanently damaged.

Pulmonary Embolism

A pulmonary embolism refers to a clot that blocks a branch of a pulmonary artery.  The tendency is for emboli to become lodged in the small branches of the pulmonary artery and restrict blood flow to some region of the lung.  Pulmonary embolisms most commonly occur in patients who are bedridden.  This is because the rate of blood flow deceases which generally increases the developments of blood clots.