Pulmonary function testing coming of age for the elderly.

Since the early days of respiratory care, known then as inhalation therapy, technicians and therapists have been called upon to measure pulmonary function values in patients of all ages. In 1975, Ruppel published his first Manual of Pulmonary Function Testing1 (now in its 10th edition), making it easier for students, educators, and therapists to learn, teach, and practice, using standardized procedures. Since then, textbooks have been published that dealt specifically with pediatric PFTs2 and infant PFTs.3 In this issue of RESPIRATORY CARE, Haynes4 addresses a PFT demographic that has often been overlooked: the elderly. Dr Tom Petty stated that “pulmonary function testing (PFT) represents the most available and most practical tool in obstructive airway disease.”5 Petty also went on to say that PFTs were sadly underutilized by the medical community in regards to the elderly, which contributed to delay and/or absence of a diagnosis in older adults.5 There has been a presumption over the years that older adults might not be able to adequately perform the breathing maneuvers needed to generate acceptable PFTs. This conjecture is not necessarily invalid, as age-related changes in physiology do include loss of elasticity and loss of muscle strength. However, research like that done by Haynes tells a different story.