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Original Research: Diffuse Lung Disease |

Interstitial Lung Disease in the Elderly

Karen C. Patterson, MD; Rupal J. Shah, MD; Mary K. Porteous, MD; Jason D. Christie, MD; Carly A. D’Errico, BA; Matthew Chadwick, BS; Matthew J. Triano, BA; Charuhas Deshpande, MD; Milton D. Rossman, MD; Leslie A. Litzky, MD; Maryl Kreider, MD; Wallace T. Miller, Jr., MD
Author and Funding Information

FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

aPulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA

bDepartment of Pathology, University of Pennsylvania, Pennsylvania, PA

cDepartment of Radiology, University of Pennsylvania, Pennsylvania, PA

dPulmonary, Critical Care, Allergy and Sleep Medicine Program, University of California, San Francisco, San Francisco, CA

CORRESPONDENCE TO: Karen C. Patterson, MD, Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, 828 W Gates, 3600 Spruce St, Philadelphia, PA 19104


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2017;151(4):838-844. doi:10.1016/j.chest.2016.11.003
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Published online

Background  Despite the relationship between idiopathic pulmonary fibrosis (IPF) and advancing age, little is known about the epidemiology of interstitial lung disease (ILD) in the elderly. We describe the diagnoses, clinical characteristics, and outcomes of patients who were elderly at the time of ILD diagnosis.

Methods  Among subjects from a prospective cohort study of ILD, elderly was defined as age ≥ 70 years. Diagnoses were derived from a multidisciplinary review. Differences between elderly and nonelderly groups were determined using the χ2 test and analysis of variance.

Results  Of the 327 subjects enrolled, 80 (24%) were elderly. The majority of elderly subjects were white men. The most common diagnoses were unclassifiable ILD (45%), IPF (34%), connective tissue disease (CTD)-ILD (11%), and hypersensitivity pneumonitis (8%). Most elderly subjects (74%) with unclassifiable ILD had an imaging pattern inconsistent with usual interstitial pneumonia (UIP). There were no significant differences in pulmonary function or 3-year mortality between nonelderly and elderly subjects combined or in a subgroup analysis of those with IPF.

Conclusions  Although IPF was the single most common diagnosis, the majority of elderly subjects had non-IPF ILD. Our findings highlight the need for every patient with new-onset ILD, regardless of age, to be surveyed for exposures and findings of CTD. Unclassifiable ILD was common among the elderly, but for most, the radiographic pattern was inconsistent with UIP. Although the effect of ILD may be more pronounced in the elderly due to reduced global functionality, ILD was not more severe or aggressive in this group.

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