Physiology of the Aging Nose and Geriatric Rhinitis
The impact of the aging world population forces rhinologists to become familiar with how aging affects both normal nasal physiology and contributes to disease. There are several aspects of nasal function that change with age. These include alterations to
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Victoria E. Varga-Huettner and Jayant M. Pinto
Keywords
Geriatrics • Nasal physiology • Rhinitis • Presbyosmia • Nasal conditioning capacity • Airflow • Treatment
Core Messages
1. Demographic trends worldwide make the knowledge of age-related changes in nasal physiology crucial for otolaryngologists. 2. Physiological changes of the nose with age include structural changes of the superstructure, alterations of the structure of the respiratory epithelium, decreased function of this epithelium manifested by decreased ciliary function, blunted vascular responses, decreased
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V.E. Varga-Huettner, MD Department of Surgery/Otolaryngology-Head and Neck Surgery, University of Chicago Medicine, 5841 South Maryland Ave, MC 1035, Chicago, IL 60637, USA e-mail: [email protected] J.M. Pinto, MD Department of Surgery/Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, 5841 South Maryland Avenue, Room E-103, MC 1035, Chicago, IL 60637, USA e-mail: [email protected]
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intranasal sensitivity and olfaction, reduced immune defense, and decreased ability to humidify air. Such changes lead to major complaints of rhinitis in older patients and contribute to a range of nasal diseases. Geriatric rhinitis is complex to categorize but can be divided by cause into allergic and nonallergic groups. Allergic causes can receive standard therapies and symptoms tend to be milder in older patients. Nonallergic causes are more difficult to treat and require careful attention to the precise triggers and symptoms; therapies are targeted to symptom. Nonspecific treatments such as humidification, mucolytics, and saline irrigations are generally safe and effective. Surgical and medical treatments for geriatric rhinitis are safe and effective, but special considerations of geriatric issues such as polypharmacy, alterations in hepatic and renal function, and sideeffect profiles must be made.
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_13, © Springer-Verlag Berlin Heidelberg 2013
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Importance of Aging in Rhinology
Societies are facing a massive demographic shift in the next 30 years, with a rapid aging of the world population. Data from the United Nations shows that in both developed and underdeveloped nations, the percentage of the population over 60 will rise significantly. Indeed, the proportion of older persons was 8 % in 1950, 10 % in 2000, and is projected to reach 21 % in 2050 (http://www.un.org/esa/population/publications/ worldageing19502050/). According to the 2010 United States Census, 13 % of the American population is greater than 65 years of age, a 15.1 % increase over the prior 10-year period (Werner 2011). Similar trends are apparent for Western Europe and even countries with younger age distributions such as China. Hence, we need to accelerate our understanding of the effects of aging and both normal physiology and disease. Given
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