Chronic obstructive pulmonary disease.

Morbidity and mortality associated with chronic airway disease are expected to continue to rise over the coming years. Accordingly, increased attention will need to be directed toward the diagnosis and treatment of COPD in the elderly population. Cessation of cigarette smoking should be pursued in all patients regardless of age. The goals of bronchodilator therapy are to reduce respiratory symptoms and to improve functional capacity without causing adverse effects. In addition, supplemental oxygen, phlebotomy for polycythemia, general exercise training, and specific respiratory muscle training may further augment exercise tolerance. Complications of COPD, such as upper respiratory infections and right heart failure, should be recognized early and treated appropriately. Implementation of a pulmonary rehabilitation program, as discussed in the next article, should complement medical therapy in the treatment of elderly patients with COPD.