Old Age or COPD?

The Effects of Aging on the Respiratory System

The respiratory system is a group of organs that work together to take in oxygen and expel carbon dioxide as you breathe. When you breathe in, oxygen-rich air goes down your windpipe and into small tubes located in your lungs. These tubes are called bronchial tubes or airways. They branch off into numerous tinier and thinner tubes known as bronchioles. At the end of the bronchioles are small, round air sacs called alveoli, which are surrounded by tiny blood vessels called capillaries. When air enters the alveoli, oxygen moves through the capillaries and into the bloodstream. At the same time, carbon dioxide moves from the capillaries into the alveoli so you can breathe it out.

Your respiratory system ages as you do, and these functions gradually decline over time. Similar to the other muscles in your body, the muscles that support your breathing become weaker. The weakening of these muscles can prevent you from inhaling and exhaling enough air. As a result, you may start breathing more shallowly to compensate, especially if you’re ill or in pain. Your lungs also become stiffer as you get older, causing them to expand and contract less easily. This can make it even more difficult to breathe. Additionally, certain changes occur in the nervous system that make coughing less effective. When you can’t clear the mucus from your lungs through coughing, large amount of particles can accumulate in the airways.

All of these age-related changes can result in an increased susceptibility to respiratory infections, such as pneumonia and the flu. You might also notice a weakened endurance for exercise or a decreased ability to do intense exercise, such as running and biking. However, even as you age, you should be able to carry out normal activities without much trouble.

In healthy people, these age-related changes rarely lead to symptoms. Importantly, age-related changes in the lungs compound the effects of heart and lung diseases, especially those caused by the destructive effects of smoking.

When It Isn’t Just Old Age

If you’re having more serious problems with your breathing, such as constant coughing and wheezing, you may have a condition known as chronic obstructive pulmonary disease (COPD). COPD is a group of progressive lung diseases, including emphysema and chronic bronchitis. The condition is most often caused by smoking or exposure to secondhand smoke. However, exposure to other lung irritants over time, such as air pollution and chemical fumes, can also contribute to the development of COPD.

People with COPD have difficulty breathing because less air is flowing into and out of the airways. This may happen for one or more of the following reasons:

  • The lungs, airways, and air sacs lose their elasticity.
  • The walls between the air sacs are destroyed.
  • The walls of the airways thicken and become swollen.
  • The airways make more mucus than normal, which can clog airways.

COPD can severely limit your ability to engage in the types of physical activities you enjoy. It can even limit your ability to perform basic daily tasks, such as showering or cleaning the house.

Common symptoms of COPD include:

  • persistent cough that produces a lot of mucus
  • shortness of breath, especially during exercise
  • wheezing sound while breathing
  • tightness in the chest

These symptoms aren’t a natural part of the aging process. So it’s important to see your doctor if you begin experiencing similar symptoms. It’s critical to get treatment as soon as possible because COPD can lead to serious complications. Once the disease progresses, your symptoms can become much worse. You should go to the emergency room right away if you experience the following symptoms:

  • difficulty talking or breathing
  • blue or gray fingernails or lips
  • lack of mental alertness
  • very fast heartbeat

Getting treatment at the first sign of COPD symptoms can significantly improve your outlook and overall quality of life. Though there is no cure for COPD, there are treatments that can help you to breathe better and remain more active. Treatment in the early stages of COPD can even slow down the progression of the disease.

Diagnosing COPD

When you visit your doctor, they will first ask about your symptoms and perform a physical examination. They may also order a chest X-ray or CT scan of your lungs. These imaging tests can show signs of COPD and help your doctor rule out other possible conditions.

In most cases, however, your doctor will use a spirometry test to diagnose COPD. During this test, you breathe as forcefully as you can into a mouthpiece attached to a spirometer. This is a handheld device that measures how quickly you can move air out of your lungs and how much air is expelled. As you age, the amount of air you can expel from your lungs decreases. However, the air you can expel is reduced even more in COPD. Your doctor will know the difference.

Sometimes, your doctor may refer you to a specialist known as a pulmonologist for more extensive testing.

Treating COPD

If you’re diagnosed with COPD, your doctor will most likely give you medications to help with your breathing. These may include:

  • bronchodilators
  • corticosteroids
  • anti-anxiety medications
  • opioids

Your doctor will also recommend that you make certain lifestyle adjustments along with medical treatment. These lifestyle changes may include:

  • quitting smoking
  • avoiding secondhand smoke
  • eating a diet of mostly natural foods, such as vegetables and fruits
  • taking vitamin and mineral supplements
  • doing low- to moderate-intensity exercise at least three times per week

In severe cases of COPD, oxygen therapy or surgery may be needed.

The Takeaway

COPD most commonly occurs in people over age 40, but it’s not a natural part of aging. You should call your doctor right away if you’re experiencing symptoms of COPD. Brushing off possible signs of the disease is dangerous and can lead to further problems in the future.

Though there is no cure for COPD, you can help reduce its effects by catching and treating it as early as possible. You can also improve your outlook by cutting out known risk factors, regardless of your age.

You Asked, We Answered

  • How can I lower my risk for COPD?
  • You can lower your risk for COPD by not smoking cigarettes and staying away from secondhand smoke. If your job requires you to come in contact with chemicals, use respiratory protection. Examples industries include bakeries, textile manufacturing plants, and coal mining. The Occupational Safety and Health Administration offers guidelines for respiratory protection.

    - Timothy J. Legg, PhD, PMHNP-BC