title: Interstitial Lung Disease in the Elderly.
abstract: 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.
  
  
  
  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 χ2test and analysis of variance.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA. Electronic address: karen.patterson@uphs.upenn.edu.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Patterson
authors.affiliation: Pulmonary, Critical Care, Allergy and Sleep Medicine Program, University of California, San Francisco, San Francisco, CA.
authors.forename: Rupal J
authors.initials: RJ
authors.lastname: Shah
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Porteous
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Christie
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Carly A
authors.initials: CA
authors.lastname: D'Errico
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Chadwick
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Triano
authors.affiliation: Department of Pathology, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Charuhas
authors.initials: C
authors.lastname: Deshpande
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Milton D
authors.initials: MD
authors.lastname: Rossman
authors.affiliation: Department of Pathology, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Litzky
authors.affiliation: Pulmonary, Allergy & Critical Care Division, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Maryl
authors.initials: M
authors.lastname: Kreider
authors.affiliation: Department of Radiology, University of Pennsylvania, Pennsylvania, PA.
authors.forename: Wallace T
authors.initials: WT
authors.lastname: Miller
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
keywords: aging; elderly; idiopathic pulmonary fibrosis; interstitial lung disease