Diffuse Parenchymal Lung Diseases in the Elderly

Purpose of Review: Diffuse parenchymal lung diseases comprise a heterogeneous group of disorders with varying clinical, physiologic, radiographic and pathologic presentations. Age of onset varies considerably. Interstitial lung abnormalities, and in particular, idiopathic pulmonary fibrosis (IPF), occur much more commonly in older persons. In recent years, advances have been made in understanding IPF pathogenesis and changes have occurred in relation to how IPF is managed. Recent Findings: The cause of IPF remains unclear. It is thought that a non-specific injury in susceptible individuals triggers a progressive fibrotic response. Genetic susceptibility is increasingly recognised. Multidisciplinary team input is essential for making a diagnosis. Although, originally thought to be an inflammatory process, it has been shown that anti-inflammatory therapies may, in fact, be harmful to the patient. Two anti-fibrotic therapies (pirfenidone and nintedanib) are now available. There is a better recognition of prognosis and improved symptom control and management of end of life issues. Summary: As life expectancy increases, further studies are necessary to assess the impact and natural history of interstitial lung diseases in the elderly.