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Deposition and clearance: unique problems in the proximal airways and oral cavity in the young and elderly

G C Smaldone1

  • 1Pulmonary/Critical Care Division, State University of New York at Stony Brook, HSC T17-040, Stony Brook, NY 11794-8172, USA. gsmaldone@mail.som.sunysb.edu

Respiration Physiology
|September 6, 2001
PubMed

Insights

Aging does not significantly alter aerosol deposition in the lungs. Disease, not age, causes deposition changes and affects clearance in obstructive lung diseases.

Area of Science:

  • Respiratory Medicine
  • Gerontology
  • Pharmacokinetics

Background:

  • Longitudinal studies on aging and respiratory aerosol behavior are lacking.
  • Aging respiratory tracts are influenced by disease and iatrogenic factors.
  • Upper airway deposition is high in children, impacting lower respiratory tract drug delivery.

Purpose of the Study:

  • To review the effects of aging on aerosol deposition and clearance in the respiratory tract.
  • To investigate the role of disease and iatrogenic causes in age-related respiratory changes.
  • To examine oral cavity clearance and its relation to pathogenic bacteria in the elderly.

Main Methods:

  • Review of existing observations on respiratory tract aging and aerosol behavior.
  • Analysis of factors influencing deposition and clearance, including disease and iatrogenic causes.
  • Examination of oral cavity and salivary clearance mechanisms in the elderly.

Main Results:

  • Aging itself has minimal impact on aerosol deposition; disease is the primary driver of abnormalities.
  • Flow limitation in central airways contributes to deposition and impaired clearance in obstructive lung diseases.
  • Oral cavity colonization by pathogens is linked to abnormal salivary clearance, often due to iatrogenic drug effects, not aging alone.

Conclusions:

  • Respiratory aerosol deposition abnormalities in older adults are mainly due to age-associated diseases, not aging per se.
  • Obstructive lung diseases significantly alter aerosol deposition and clearance, influenced by airway flow limitations.
  • Iatrogenic factors, particularly medications, play a crucial role in impaired salivary clearance and oral pathogen colonization in the elderly.

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