CT features of normal lung change in asymptomatic elderly patients

Abstract

Abstract Background Not all morphological lung changes in the elderly contribute to respiratory disease and may be a consequence of normal aging. Objectives To describe the changes in asymptomatic elderly patients compared with those in younger patients in a Thai population. Methods The study cohort comprised 60 participants without respiratory symptoms in three groups of 20 by age: 20-40 years, 41-60 years, and >60 years. Participants were prospectively selected from patients referred for computed tomography (CT) of the abdomen, or head and neck, and underwent sequential CT during deep breathing at four lung levels. Two observers scored images by consensus. We compared groups using Pearson chi-square and Fisher exact tests, and used receiver operating characteristic curves to categorize bronchiectasis and bronchial wall thickening by age. Results Air trapping was related to age (5/20 group 1, 7/20 group 2, and 18/20 group 3 (P <0.01)) and was most prevalent in lower lobes (78%, P < 0.01). Reticulation was found in only one middle aged patient (P = 0.36). Bronchiectasis was more common in patients <56 years (7/23) than <56 years (3/37), P = 0.035. Bronchial wall thickening (7/23 in patients >56 years and 2/37 in patients <56 years, P = 0.02) and extensive air trapping were related to age (0/6 group 1, 1/6 group 2, and 5/6 group 3, P = 0.02). Findings were independent of smoking history. Conclusions Asymptomatic older patients had higher prevalence of bronchiectasis, bronchial wall thickening, and air trapping, independent of smoking history.