Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T10:00:30.011Z Has data issue: false hasContentIssue false

Respiratory disease in old age

Published online by Cambridge University Press:  17 November 2008

EC Pulford*
Affiliation:
University of Manchester, Manchester, UK
Martin J Connolly
Affiliation:
University of Manchester, Manchester, UK
*
University of Manchester, Robert Barnes Medical Unit, Barnes Hospital, Kingsway, Cheadle, Cheshire SK8 2NY, UK.

Abstract

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Teale, C, Romianiuk, C, Mulley, G. Calcification on chest radiographs; the association with age. Age Ageing 1989; 18: 333–36.CrossRefGoogle ScholarPubMed
2Milne, JS. Longitudinal respiratory studies in older people. Thorax 1978; 33: 547–54.CrossRefGoogle ScholarPubMed
3Milne, JS, Williamson, J. Respiratory function tests in older people. Clin Sci 1972; 42: 371–81.Google Scholar
4Enright, PL, Kronmal, RA, Higgins, M, Schenker, M, Hapenik, EF. Spirometry reference values for men and women 65 to 85 years of age. Cardiovascular Health Study. Am Rev Respir 1993; 147: 125–33.Google Scholar
5Knudson, RJ, Slatin, RC, Leibowitz, MD, Burrows, B. The maximal expiratory flow-volume curve, normal standards, variability and effects of age. Am Rev Respir Dis 1876: 113: 587600.Google Scholar
6Young, RC, Borden, DL, Rachal, RE. Ageing of the lung: pulmonary disease in the elderly. Age 1987; 10: 138–45.Google Scholar
7Connolly, MJ, Crowley, JJ, Vestal, RE. Clinical significance of crepitations in elderly patients following acute hospital admission: a prospective study. Age Ageing 1992; 21: 4348.Google Scholar
8Connolly, MJ, Crowley, JJ, Charan, NB, Nielson, CP, Vestal, RE. Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale. Thorax 1992; 47: 410–13.Google Scholar
9Bortz, WM. Disuse and ageing. J Am Med Assoc 1982; 248: 1203–208.CrossRefGoogle Scholar
10Larson, EB, Bruce, RA. Health benefits of exercise in an ageing society. Arch Intern Med 1987; 147: 353–56.CrossRefGoogle Scholar
11Esposito, AL. The effect of common pharmacologie agents on pulmonary antibacterial defenses: implications for the geriatric patient. Clin Chest Med; Resp infect. 1987; 8: 373–80.CrossRefGoogle Scholar
12MacFarlane, J. Community acquired pneumonia. Br J Dis Chest 1987; 81: 116–27.CrossRefGoogle ScholarPubMed
13Venkatesan, P, Gladman, J, MacFarlane, JT et al. A hospital study of community acquired pneumonia in the elderly. Thorax 1990; 45: 254–58.CrossRefGoogle ScholarPubMed
14Saltzman, RL, Peterson, PK. Immunodeficiency of the elderly. Rev Infect Dis 1987; 9: 1127–39.CrossRefGoogle ScholarPubMed
15Katsumata, U, Tagasugi, R, Kotaku, K, Sekizawa, H, Sasaki, T, Takashima, T. Cough reflex does not decline with age. Am Rev Respir Dis 1991; 143: A535.Google Scholar
16Goodman, RM, Vergin, BM, Landa, JF, Gollinvaux, MH, Sackner, MA. Relationship of smoking history and pulmonary function tests to tracheal mucus velocity in nonsmokers, young smokers, exsmokers and patients wtih chronic bronchitis. Am Rev Respir Dis 1978; 117: 205–14.Google Scholar
17Hope-Simpson, RE, Higgins, PG. A respiratory virus study in Great Britain: review and evaluation. Prog Med Virol 1969; 11: 354407.Google Scholar
18Anthonisen, NR, Manfreda, J, Warren, CPW, Hershfield, ES, Harding, GKM, Nelson, NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987; 106: 196204.CrossRefGoogle ScholarPubMed
19Vikerfors, T, Grandien, M, Olcen, P. Respiratory syncytial virus infection in adults. Am Rev Respir Dis 1987; 136: 561–64.CrossRefGoogle ScholarPubMed
20Curwan, M, Dunnell, K, Ashley, J. Hidden influenza deaths. BMJ 1990; 300: 896.Google Scholar
21Bryson, YJ, Monahan, C, Pollack, M, Shields, WD. A prospective double-blind study of side-effects associated with amantadine for influenza A prophylaxis. J Infect Dis 1980; 141: 543–47.Google Scholar
22Joint Committee on Vaccination and Immunisation. Department of Health. Immunisation against infectious disease. London: HMSO, 1992.Google Scholar
23Morgan, R, King, D, Turnbull, CJ. Influenza vaccination: do the aged reap the benefit? Postgrad Med J 1995; 71: 2223.Google Scholar
24Nicholson, KG, Baker, DJ, Farquhar, A, Hurd, D, Kent, J, Smith, SH. Acute upper respiratory tract viral illness and influenza immunisation in homes for the elderly. Epidemiol Infect 1990; 105: 609–18.CrossRefGoogle ScholarPubMed
25Schwarzmann, SW, Adler, JL, Sullivan, RJ, Marine, WM. Bacterial pneumonia during the Hong Kong influenza epidemic of 1968–9. Arch Intern Med 1971; 127: 1037–41.CrossRefGoogle Scholar
26Birmingham Research Unit of the Royal College of General Practitioners. Weekly Returns Service, report for 1992. London: Royal College of General Practitioners, 1993.Google Scholar
27Boldy, DAR, Steadman, SJ, Ayres, JG. Acute bronchitis in the community: clinical features, infective factors, changes in pulmonary function and bronchial reactivity to histamine. Respir Med 1990; 84: 377–85.Google Scholar
28The British Thoracic Society and The Public Health Laboratory Service. Commuity-acquired pneumonia in adults in British hospitals in 1982–1983: a survey of aetiology, mortality, prognostic factors and outcome. Q J Med 1987; 239: 195220.Google Scholar
29Marrie, TJ, Durant, H, Yates, L. Community-acquired pneumonia requiring hospitalization: 6-year prospective study. Rev Infect Dis 1989; 11: 586–99.CrossRefGoogle Scholar
30Marrie, TJ. New aspects of old pathogens of pneumonia. Med Clin North Am 1994; 78: 987–95.Google Scholar
31Farr, BM, Sloman, AJ, Fisch, MJ. Predicting death in patients hospitalized for community-acquired pneumonia. Ann Intern Med 1991; 115: 428–36.CrossRefGoogle ScholarPubMed
32Venkatesan, P, Gladman, J, Macfarlane, JT et al. A hospital study of community-acquired pneumonia in the elderly. Thorax 1995; 45: 254–58.Google Scholar
33Marrie, TJ, Durant, H, Yates, L. Community-acquired pneumonia requiring hospitalisation: 5-year prospective study. Rev Infect Dis 1989; 11: 586–99.Google Scholar
34Marrie, TJ, Haldane, EV, Falkner, RS, Durant, H, Kwan, C. Community-acquired pneumonia requiring hospitalization: is it different in the elderly? J Am Geriatr Soc 1985; 33: 671–79.Google Scholar
35Starczewski, AR, Allen, SC, Vargas, E, Lye, M. Clinical prognostic indices of fatality in elderly patients admitted to hospital with acute pneumonia. Age Ageing 1988; 17: 181–86.Google Scholar
36LaCroix, AZ, Lipson, S, Miles, TP, White, L. Prospective study of pneumonia hospitalizations and mortality of US older people: the role of chronic conditions, health behaviours and nutritional status. Public Health Rep 1989; 104: 350–60.Google ScholarPubMed
37Brancati, FL, Chow, JW, Wagener, MM, Vacarello, SJ, Yu, VL. Is pneumonia really the old man's friend? Two-year prognosis after community acquired pneumonia. Lancet 1993; 342 (8862): 3033.Google Scholar
38Esposito, AL. Community-acquired bacteremic pneumococcal pneumonia. Effect of age on manifestations and outcome. Arch Intern Med 1984; 144: 945–48.Google Scholar
39Harper, C, Newton, P. Clinical aspects of pneumonia in the elderly veteran. J Am Geriatr Soc 1989; 37: 867–72.CrossRefGoogle ScholarPubMed
40Puxty, JAH, Andrews, K. The role of chest radiography in the evaluation of ‘geriatric giants’. Age Ageing 1986; 15: 174–76.Google Scholar
41McFadden, JP, Price, RC, Eastwood, HD, Briggs, RS. Raised respiratory rate in elderly patients: a valuable physical sign. BMJ 1982; 284: 626–27.CrossRefGoogle ScholarPubMed
42British Thoracic Society. Guidelines for the management of community-acquired pneumonia in adults admitted to hospital. Br J Hosp Med 1993; 49: 346–50.Google Scholar
43American Thoracic Society. Guidelines for the management of adults with community-acquired pneumonia: diagnosis, assessment, severity, and initial antimicrobial therapy. Am Rev Respir Dis 1993; 148: 1418–26.Google Scholar
44Farr, BM, Kaiser, DL, Harrison, BDW, Connolly, CK. Prediction of microbial aetiology at admission to hospital for pneumonia from presenting clinical features. Thorax 1989; 44: 1031–35.Google Scholar
45Levy, M, Dromer, F, Brion, N, Leterdu, F, Carbon, C. Community-acquired pneumonia. Importance of initial noninvasive bacteriologie and radiographic investigations. Chest 1988; 92: 4348.Google Scholar
46Saviteer, SM, Samsa, GP, Rutala, WA. Nosocomial infections in the elderly – increased risk per hospital day. Am J Med 1988; 84: 661–67.CrossRefGoogle ScholarPubMed
47Harkness, GA, Bentley, DW, Roghmann, KJ. Risk factors for nosocomial pneumonia in the elderly. Am J Med 1990; 89: 457–63.Google Scholar
48Zaidi, NH, Smith, HA, King, SC, Park, C, O'Neill, P, Connolly, MJ. Oxygen desaturation on swallowing as a potential marker of aspiration in acute stroke. Age Ageing 1995; 24: 267–70.CrossRefGoogle ScholarPubMed
49Horan, TC, White, JW, Jarvis, WR et al. Nosocomial infection surveillance. MMWR CDC Surveill Summ 1984; 34: 17SS29SS.Google Scholar
50Brennen, C, Vickers, RM, Yu, VL, Puntereri, A, Yee, YC. Discovery of occult legionella pneumonia in a long-stay hospital: results of prospective serological survey. BMJ 1987; 295: 306307.CrossRefGoogle Scholar
51Hilf, M, Yu, VL, Sharp, J, Zuravleff, JJ, Korvick, JA, Muder, RR. Antibiotic therapy for Pseudomonas aeruginosa bacteraemia: outcome correlation in a prospective study of 200 patients. Am J Med 1989; 87: 540–46.Google Scholar
52Hill, SL, Morrison, HM, Burnett, D, Stockley, RA. Short-term response of patients with bronchiectasis to treatment with amoxycillin given in standard or high doses orally or by inhalation. Thorax 1986; 41: 559–65.Google Scholar
53Morris, CDW, Nell, H. Epidemic of pulmonary tuberculosis in geriatric homes. S Afr Med J 1988; 74: 117–20.Google Scholar
54Kearney, HT, Wanklyn, PD, Goldman, JM, Pearson, SB, Teale, C. Urban deprivation and tuberculosis in the elderly. Respir Med 1994; 88: 703704.CrossRefGoogle ScholarPubMed
55Morris, CDW, Bird, AR, Nell, H. Haematological and biochemical changes in severe pulmonary tuberculosis. Q J Med 1989; 73: 1151–59.Google Scholar
56Counsell, S, Tan, JS, Dittus, RS. Unsuspected pulmonary tuberculosis in a community teaching hospital. Arch Intern Med 1989; 149: 1274–78.CrossRefGoogle Scholar
57Teale, C, Goldman, JM, Pearson, SB. The association of age with the presentation and outcome of tuberculosis: a five-year survey. Age Ageing 1993; 22: 289–93.CrossRefGoogle ScholarPubMed
58Joint Tuberculosis Committee of the British Thoracic Society. Chemotherapy and the management of tuberculosis in the United Kingdom: recommendations of the Joint Tuberculosis Committee of the British Thoracic Society. Thorax 1990; 45: 403408.CrossRefGoogle Scholar
59Connolly, MJ, Magee, JG, Hendrick, DJ, Jenkins, PA. Mycobacteria malmoense in the northeast of England. Tubercle 1985; 66: 211–17.CrossRefGoogle ScholarPubMed
60Knox, AJ, Mascie-Taylor, H, Page, RL. Fibreoptic bronchoscopy in the elderly: 4 years' experience. Br J Dis Chest 1988; 82: 290–93.CrossRefGoogle ScholarPubMed
61Heaton, RW. Should patients with haemoptysis and a normal chest X-ray be bronchoscoped? Postgrad Med J 1987; 63: 947–49.Google Scholar
62Spiro, SG, Souhami, RL. Duration of chemotherapy in small cell lung cancer. Thorax 1990; 45: 12.Google Scholar
63Smit, EF, Carney, DN, Harford, P, Sleijfer, DT, Postmus, PE. A phase II study of oral etoposide in elderly patients with small cell lung cancer. Thorax 1989; 44: 631–33.CrossRefGoogle ScholarPubMed
64Poplin, E, Thompson, B, Whitacre, M, Ainser, J. Small cell carcinoma of the lung: influence of age on treatment outcome. Cancer Treat Rep 1987; 71: 291–96.Google Scholar
65Kelly, P, O'Brien, AAJ, Daly, P, Clancy, L. Small-cell lung cancer in elderly patients: the case for chemotherapy. Age Ageing 1991; 20: 1922.CrossRefGoogle Scholar
66Carney, DN, Byrne, A. Etoposide in the treatment of elderly/poor prognosis patients with small-cell lung cancer. Cancer Chemother Pharmacol 1994; 34: S96–S100.CrossRefGoogle ScholarPubMed
67Byrne, A, Carney, DN. Small cell lung cancer in the elderly. Semin Oncol 1994; 21 (suppl 6): 4348.Google ScholarPubMed
68Shirakusa, T, Tsutsui, M, Iriki, N et al. Results of resection for bronchogenic carcinoma in patients over the age of 80. Thorax 1989; 44: 189–91.Google Scholar
69Mãné, JM, Estapé, J, Sánchez-Lloret, J et al. Age and clinical characteristics of 1433 patients with lung cancer. Age Ageing 1994; 23: 2831.CrossRefGoogle ScholarPubMed
70Souquet, PJ, Chauvin, F, Beissel, JP et al. Polychemotherapy in advanced non-small cell cancer: a meta-analysis. Lancet 1993; 342: 1921.Google Scholar
71Lung and Asthma Information Agency. Factsheet 92/3: pleural mesothelioma. London: Department of Public Health Sciences, 1992.Google Scholar
72Hunt, A. The elderly at home. A study of people aged sixty-five and over in the community in 1976. London: HMSO, 1976.Google Scholar
73Rijcken, B, Scheuten, JP, Rosner, B, Weiss, ST. Is it useful to distinguish between asthma and chronic obstructive pulmonary disease in respiratory epidemiology? Am Rev Respir Dis 1991; 143: 1456–57.Google Scholar
74British Thoracic Society. Guidelines on the management of asthma. Thorax 1993; 48: S1–S24.Google Scholar
75Braman, SS, Kaemmerlen, JT, Davis, SM. Asthma in the elderly. A comparison between patients with recently acquired and long-standing disease. Am Rev Respir Dis 1991; 143: 336–40.Google Scholar
76Peat, JK, Woolcock, AJ, Cullen, K. Rate of decline of lung function in subjects with asthma. Eur J Respir Dis 1987; 70: 171–79.Google Scholar
77Kawakami, Y, Kishi, F, Dohsaka, K, Nishiura, Y, Suzuki, A. Reversibility of airway obstruction in relation to prognosis in chronic obstructive pulmonary disease. Chest 1988; 93: 4953.Google Scholar
78Dodge, R, Cline, MG, Burrows, B. Comparisons of asthma, emphysema and chronic bronchitis diagnoses in a general population sample. Am Rev Respir Dis 1986; 133: 981–86.Google Scholar
79Banerjee, DK, Lee, GS, Malik, SK, Daly, S. Underdiagnosis of asthma in the elderly. Br J Dis Chest 1987; 81: 2329.CrossRefGoogle ScholarPubMed
80Burr, ML, Charles, TJ, Roy, K, Seaton, A. Asthma in the elderly: an epidemiological survey. BMJ 1979; 1: 1041–44.CrossRefGoogle ScholarPubMed
81Dodge, RR, Burrows, B. The prevalence and incidence of asthma and asthma-like symptoms in a general population sample. Am Rev Respir Dis 1980; 122: 567–75.Google Scholar
82Sparrow, D, O'Connor, G, Colton, T, Barry, CL, Weiss, ST. The relationship of nonspecific bronchial responsiveness to the occurrence of respiratory symptoms and decreased levels of pulmonary function. The normative aging study. Am Rev Respir Dis 1987; 135: 1255–60.CrossRefGoogle Scholar
83Nielson, CP, Crowley, J, Vestal, RE, Connolly, MJ. Impaired beta-adrenoceptor function, increased leucocyte respiratory burst and bronchial hyperresponsiveness. J Allergy Clin Immunol 1992; 90: 825–32.CrossRefGoogle ScholarPubMed
84Connolly, MJ. Ageing, late-onset asthma and the beta-adrenoceptor. Pharmacol Ther 1993; 60: 389404.CrossRefGoogle ScholarPubMed
85Sherrill, DL, Nalonen, M, Burrows, B. Relationship between total serum IgE, atopy, and smoking: a twenty-year follow-up analysis. J Allergy Clin Immunol 1994; 94 (6 Pt 1): 954–62.Google Scholar
86Burrows, B, Lebowitz, MD, Barbee, RA, Cline, MG. Findings before diagnosis of asthma among the elderly in a longitudinal study of a general population sample. J Allergy Clin Immunol 1991; 88: 870–77.Google Scholar
87Tollerud, DJ, O'Connor, GT, Spararow, D, Weiss, ST. Asthma, hay fever and phlegm production associated with distinct patterns of allergy skin test reactivity, eosinophilia, and serum IgE levels. The normative ageing study. Am Rev Respir Dis 1991; 144: 776–81.Google Scholar
88Dow, L, Coggon, D, Campbell, MJ, Osmond, C, Holgate, ST. The interaction between immunoglobulin E and smoking in airflow obstruction in the elderly. Am Rev Respir Dis 1992; 146: 402407.Google Scholar
89Shirakawa, T, Li, A, Dubowitz, M et al. Association between atopy and variants of the beta-subunit of the high-affinity immunoglobulin E receptor. Nat Genet 1994; 7: 125–29.Google Scholar
90Petheram, IS, Jones, DA, Collins, JV. Assessment and management of acute asthma in the elderly: a comparison with younger asthmatics. Postgrad Med J 1982; 58: 149–51.Google Scholar
91Boezen, HM, Scheuten, JP, Postma, DS, Rijcken, B. Relation between respiratory symptoms, pulmonary function and peak flow variability in adults. Thorax 1995; 50: 121–26.CrossRefGoogle ScholarPubMed
92Sherman, CB, Xu, X, Speizer, FE, Ferris, BG Jr, Weiss, ST, Dockery, DW. Longitudinal lung function decline in subjects with respiratory symptoms. Am Rev Respir Dis 1992; 146: 855–59.CrossRefGoogle ScholarPubMed
93O'Connor, GT, Sparrow, D, Segal, M, Weiss, ST. Risk factors for ventilatory impairment among middle-aged and elderly men. The normative aging study. Chest 1993; 102: 376–82.CrossRefGoogle Scholar
94Renwick, DS, Connolly, MJ. Respiratory symptoms in older adults: the effects of age and smoking habit. Age Ageing 1995; 24: (suppl 2): 13.Google Scholar
95Dow, L, Coggon, D, Holgate, ST. Respiratory symptoms as predictors of airways lability in an elderly population. Respir Med 1992; 86: 2732.Google Scholar
96Diggory, P, Cassels-Brown, A, Vail, A, Abbey, LM, Hillman, JS. Avoiding unsuspected respiratory side effects of topical timolol with cardioselective or sympathomimetic agents. Lancet 1995; 345: 1604–606.CrossRefGoogle ScholarPubMed
97Committee on Safety of Medicines. Report of the beta-agonist working party. London: Medicines Control Agency, 1992.Google Scholar
98Connolly, MJ, Kelly, C, Walters, EH, Hendrick, DJ. An assessment of methacholine inhalation tests in the elderly. Age Ageing 1988; 17: 123–28.Google Scholar
99Allen, SC, Prior, A. What determines whether an elderly patient can use a metered dose inhaler correctly? Br J Dis Chest 1986; 80: 4549.Google Scholar
100White, CS, Cole, RP, Lubetsky, HW, Austin, JHM. Acute asthma: admission chest radiography in hospitalized adult patients. Chest 1991; 100: 1416.CrossRefGoogle ScholarPubMed
101Connolly, MJ, Renwick, DS, Gibson, HN, Taylor, PM. Admission chest radiograph (CXR) in elderly patients admitted to hospital with acute severe asthma. Age Ageing 1995; 24 (suppl 2) 13.CrossRefGoogle Scholar
102Eaton, D, Bannister, P, Mulley, GP, Connolly, MJ. Axillary sweating: an important physical sign in the clinical assessment of dehydration in ill elderly patients. BMJ 1994; 308: 1271.Google Scholar
103Bowler, SD, Mitchell, CA, Armstrong, JG. Corticosteroids in acute severe asthma: effectiveness of low doses. Thorax 1992; 47: 584–87.Google Scholar
104Otulana, BA, Varma, N, Bullock, A, Higgenbottam, T. High-dose nebulized steroid in the treatment of chronic steroid-dependent asthma. Resp Med 1992; 86: 105108.Google Scholar
105Whyte, KF, Gould, GA, Jeffrey, AA, Airlie, MAA, Flenley, DC, Douglas, NJ. Dose of nebulized ipratropium bromide in acute severe asthma. Rerspir Med 1991; 85: 517–20.Google Scholar
106Teale, C, Morrison, JFJ, Muers, MF, Pearson, SB. Response to nebulized ipratropium bromide and terbutaline in acute severe asthma. Respir Med 1992; 86: 215–18.Google Scholar
107Siegel, D, Sheppard, D, Gelb, A, Weinberg, PF. Aminophylline increases the toxicity but not the efficacy of an inhaled beta-adrenergic agonist in the treatment of acute exacerbations of asthma. Am Rev Respir Dis 1985; 132: 283–86.Google Scholar
108Self, TH, Abou-Shala, N, Burns, R et al. Inhaled albuterol and oral prednisone therapy in hospitalised adult asthmatics. Does aminophylline add any benefit? Chest 1990; 98: 1317–21.Google Scholar
109Murphy, DG, McDermott, MJ, Rydman, RJ, Sloan, EP, Zalenski, T. Aminophylline in the treatment of acute asthma when β2-adrenergics and steroids are provided. Arch Intern Med 1993; 153: 1784–88.Google Scholar
110Wrenn, K, Slovis, CM, Murphy, F, Greenberg, RS. Aminophylline therapy for acute bronchospastic disease in the emergency room. Ann Intern Med 1991; 115: 241–47.CrossRefGoogle ScholarPubMed
111Huang, D, O'Brian, RG, Karman, E et al. Does aminophylline benefit adults admitted to the hospital for an acute exacerbation of asthma? Ann Intern Med 1993; 119: 1155–60.Google Scholar
112Wrenn, K, Slovis, CM, Murphy, F, Greenberg, RS. Aminophylline therapy for acute bronchospastic disease in the emergency room. Ann Intern Med 1991; 115: 241–47.Google Scholar
113Cannigia, A, Muti, R, Lore, F, Valtimo, A. Pathophysiology of the adverse effects of glucoactive corticosteroids on calcium metabolism in man. J Steroid Metab 1981; 15: 153–61.Google Scholar
114Boulet, LP, Giguere, MC, Milot, J, Brown, J. Effects of long-term use of high-dose inhaled steroids on bone density and calcium metabolism. J Allergy Clin Immunol 1994; 94: 796803.Google Scholar
115Selroos, O, Halme, M. Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler. Thorax 1991; 46: 891–94.Google Scholar
116Armitage, JM, Williams, SJ. Inhaler technique in the elderly. Age Ageing 1988; 117: 275–78.Google Scholar
117Allen, SC. Competence thresholds for use of inhalers in people with dementia. Age Ageing 1995; 24 (suppl 2) 13.Google Scholar
118Harvey, J, Williams, JG. Randomised cross-over comparison of five inhaler systems for bronchodilator therapy. Br J Clin Pract 1992; 46: 249–51.Google Scholar
119Connolly, MJ. Inhaler technique of elderly patients: comparison of metered-dose inhalers and large volume spacer devices. Age Ageing 1995; 24: 190–92.Google Scholar
120Trigg, CJ, Davies, RJ. Use of slow-release theophylline in asthma – is it justified? Respir Med 1990; 84: 13.Google Scholar
121Martin, RJ. Nocturnal asthma: circadian rhythms and therapeutic intervention. Am Rev Respir Dis 1993; 147: S25–S28.Google Scholar
122Higgins, BG, Francis, HC, Warburton, CJ, Fletcher, AM, Pickering, CAC, Woodcock, AA. Effects of air pollution on symptoms and peak expiratory flow measurements in subjects with obstructive airways disease. Thorax 1995; 50: 149–55.Google Scholar
123Thurlock, WM. Pathophysiology of chronic obstructive pulmonary disease. In: Hodgkin, JE ed. Clinics in chest medicine: chronic obstructive pulmonary disease. Philadelphia: WB Saunders Company, 1990: 389403.Google Scholar
124Dompeling, E, van Schayck, CP, Forgering, H et al. Inhaled beclomethasone improves the course of asthma and COPD. Eur Respir J 1992; 5: 945–52.Google Scholar
125Mann, JS, George, CF. Anticholinergic drugs in the treatment of airways disease. Br J Dis Chest 1985; 79: 209–28.Google Scholar
126Postma, DS. Inhaled therapy in COPD: what are the benefits? Respir Med 1991; 85: 447–49.Google Scholar
127O'Driscoll, R. Home nebulized therapy – is it effective? [Editorial]. Respir Med 1991; 85: 13.Google Scholar
128Teale, C, Morrison, JFJ, Jones, PC, Muers, MF. Reversibility tests in chronic obstructive airways disease: their predictive value with reference to benefit from domiciliary nebuliser therapy. Respir Med 1991; 85: 281–84.CrossRefGoogle ScholarPubMed
129Evald, T, Keittelmann, S, Sindrup, JH, Lange, P. The effect of inhaled terbutaline on FEV1, FVC, and dyspnoea and walking distance in patients with chronic obstructive lung disease. Respir Med 1992; 86: 9396.Google Scholar
130Morrison, JF, Jones, PC, Muers, MF. Assessing physiological benefit from domiciliary nebulised bronchodilators in severe airflow limitation. Eur Resp J 1992; 5: 424–29.Google Scholar
131O'Driscoll, BR, Kay, EA, Taylor, RJ, Bernstein, A. Home nebulisers: can optimal therapy be predicted by laboratory studies? Respir Med 1990; 84: 471–77.Google Scholar
132Medical Research Council working party. Long-term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema. Lancet 1981; i: 681–86.Google Scholar
133Kawakami, Y. Prognostic factors in COPD: the importance of pulmonary haemodynamic variables. Pract Cardiol 1985; 11: 124–37.Google Scholar
134Burchfiel, CM, Marcus, EB, Curb, D. Effects of smoking and smoking cessation on longitudinal decline in pulmonary function. Am J Respir Crit Care Med 1995; 151: 1778–85.Google Scholar
135Vetter, NJ, Ford, D. Smoking prevention among people aged 60 and over: a randomized controlled trial. Age Ageing 1990; 19: 164–68.Google Scholar
136Barter, CE, Campbell, AH. Relationship of constitutional factors and cigarette smoking to decrease in 1-second forced expiratory volume. Am Rev Respir Dis 1976; 113: 305–14.Google Scholar
137Villar, TA, Dow, L, Coggon, D, Lampe, FC, Holgate, ST. The influence of bronchial responsiveness, atopy and serum IgE on decline in FEV1. Am J Respir Crit Care Med 1995; 151: 656–62.Google Scholar
138Nocturnal Oxygen Therapy Trial Group. Continuous or nocturnal oxygen therapy in hypoxaemic chronic obstructive lung disease. A clinical trial. Ann Intern Med 1980; 93: 391–98.Google Scholar
139Heaton, RK, Grant, I, McSweeney, AJ, Adams, KM, Petty, TL. Psychologic effects of continuous and nocturnal oxygen therapy in hypoxaemic chronic obstructive pulmonary disease. Arch Intern Med 1983; 143: 1941–47.Google Scholar
140Mant, A, Eyland, EA, Hewitt, H et al. Sleep-disordered breathing in elderly people and subjective sleep-wake disturbance. Age Ageing 1992; 21: 262–68.Google Scholar
141Hogg, JC, Pare, PP, Wright, JL. In: Sluiter HJ, van der Lande R, eds. Maastricht: Van Gorcum. 1989: 123–32.Google Scholar
142Tetley, TD. Emphysema revisited. Respir Med 1992; 86: 187–93.Google Scholar
143Winkelmann, BR, Kullmer, TH, Kniessl, DG, Trenk, D, Kronenberger, H. Low-dose almitrine bismesy-late in the treatment of hypoxia due to chronic obstructive pulmonary disease. Chest 1994; 105: 1383–91.CrossRefGoogle ScholarPubMed
144Bardsley, PA, Tweney, J, Morgan, N, Howard, P. Oral almitrine in treatment of acute respiratory failure and cor pulmonale in patients with an exacerbation of chronic obstructive airways disease. Thorax 1991; 46: 493–98.Google Scholar
145Stewart, AG, Marsh, F, Waterhouse, JC, Howard, P. Autonomic nerve dysfunction as assessed by the acetylcholine sweatspot test in chronic obstructive pulmonary disease. Eur Respir J 1994; 7: 1090–95.Google Scholar
146Stewart, AG, Waterhouse, JG, Howard, P. The QTc interval, autonomic neuropathy and mortality in hypoxaemic COPD. Respir Med 1995; 89: 7984.Google Scholar
147Masood, AR, Reed, JW, Thomas, SHL. Lack of effect of inhaled morphine on exercise-induced breathlessness in chronic obstructive pulmonary disease. Thorax 1995; 50: 629–35.Google Scholar
148Davis, C, Hodder, C, Love, S, Shah, R, Slevin, M, Wedzicha, J. Effect of nebulised morphine and morphine-6-glucuronide on exercise endurance in patients with chronic obstructive pulmonary disease [abstract]. Thorax 1994; 49: 393P.Google Scholar
149Woodcock, AA, Gross, ER, Gellert, A, Shah, S, Johnson, M, Geddes, DM. Effects of dihydrocodeine, alcohol, and caffeine on breath lessness and exercise tolerance in patients with chronic obstructive lung disease and normal blood gases. N Engl J Med 1981; 305: 1611–16.Google Scholar
150Britton, J, Pavord, I, Richards, K et al. The effects of dietary antioxidants on lung function in the general population. Am Rev Respir Dis 1993; 147: 369.Google Scholar
151Schwartz, J, Weiss, ST. Relationship between dietary Vitamin C intake and pulmonary function in the first national health and nutrition survey (NHANES 1). Am J Clin Nutr 1994; 59: 110–14.Google Scholar
152The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study Group. The effect of Vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 1994; 330: 1029–35.Google Scholar
153 Beta-carotene, vitamin E, and lung cancer [Letters]. N Engl J Med 1994; 331: 611–14.Google Scholar
154van Schayck, CP, van Herwaarden, CLA [Editorial]. Thorax 1993; 43: 470–73.CrossRefGoogle Scholar
155Taylor, DR, Sears, MR. Bronchodilators and bronchial hyperresponsiveness [Letter]. Thorax 1994; 49: 190.Google Scholar
156Sears, MR, Taylor, DR, Print, CG et al. Regular inhaled beta-agonist treatment in bronchial asthma. Lancet 1990; 336: 1391–96.Google Scholar
157van Schayck, CP, Dompeling, E, van Herwaarden, CLA et al. Bronchodilator treatment in moderate asthma or chronic bronchitis: continuous or demand? A randomised controlled study. BMJ 1991; 303: 1426–31.Google Scholar
158Patakas, D, Maniki, E, Tsara, V, Daskalopoulou, E. Intermittent and continuous salbutamol rotacaps inhalation in asthmatic patients. Respiration 1988; 54: 174–78.Google Scholar
159Kuitert, LM. Beta-agonists in asthma – state of the art: report on a Royal Society of Medicine seminar. Thorax 1992; 47: 568–69.Google Scholar