Older Patients With Interstitial Lung Disease Feature a Distinct Clinical Profile

Abstract

Introduction

There are few studies investigating the clinical profile of older patients with interstitial lung disease (ILD), so this study investigated the characteristics of the older population diagnosed with ILD.

Material and methods

Retrospective study in a population of new referrals at an ILD clinic from January 2013 to September 2017. Patients over 64 years were selected. Data collection included diseases variables, diagnostic procedures and comorbidities. Gender-age-physiology (GAP) stage, composite physiologic index (CPI) and Charlson index was calculated. Statistical analysis was performed to investigate risk factors associated with survival.

Results

A total of 232 patients were included in this study. Mean age was 76.3 years (SD 6.5). As per protocol, 69.3% completed the initial assessment but this was lower in the elderly group (61.5%). The most frequent diagnosis was unclassifiable ILD (24.1%), followed by ILD associated with connective tissue disease (21.6%), IPF (12.1%) and hypersensitivity pneumonitis (10.3%). During follow-up (36.7 months (SD 28.6)) a significant proportion of patients died (55 cases, 23.7% of the cohort), especially in the late older group (30.4%). Kaplan–Meier curves showed that those over 75 years have a worse survival even when adjusted by covariables (p < 0.001). CPI was the only score with statistical significance in a multivariate analysis (HR 1.06. p 0.006).

Conclusions

Older adults with ILD featured a distinct clinical profile. Our findings highlight the need to develop non-invasive biomarkers and specific scores adapted to this age-group.