Lung morphology in the elderly: comparative CT study of subjects over 75 years old versus those under 55 years old

To describe thin-section pulmonary computed tomographic (CT) features in asymptomatic elderly individuals.

Institutional review board approval was given, and informed consent was obtained. Two study groups (older group, over 75 years of age; younger group, under 55 years) were prospectively identified from outpatient requests for CT of the abdomen or brain. Fifty-six consecutive volunteers (older group: n = 40, 18 men, 22 women; younger group: n = 16, eight men, eight women) with no known respiratory disease were included. Prone thin-section CT imaging was performed, and two observers independently scored images for the presence and extent of CT features (including reticular pattern, ground glass opacity, and thin-walled cystic air spaces). Group comparisons were made, and logistic regression analysis was used to assess relationships between CT findings and age and smoking history.

A limited predominantly subpleural basal reticular pattern was identified in the majority (24 of 40, 60%) of individuals in the older group and was absent (zero of 16) in the younger group (P < .001). Cysts were seen in 10 (25%) of the 40 subjects in the older group but were seen in none of the subjects in the younger group (P = .02). Bronchial dilation and wall thickening were also seen significantly more frequently (P < .001) in the older group (24 [60%] and 22 [55%] of 40, respectively) than in the younger group (both one [6%] of 16). All findings were independent of pack-year smoking history with multiple logistic regression analysis.

Thin-section CT findings usually associated with interstitial lung disease are frequently seen in asymptomatic elderly individuals and are absent in younger subjects. Therefore, these findings may not necessarily represent clinically relevant disease.