Which assessment variations in the thorax and lungs of the older adult may be present? (Select all that apply)

Pulmonary senescence involves a progressive decline in chest wall compliance and a reduction in the total surface area for gas exchange. The calcification of costal cartilages restricts thoracic expansion, while the loss of alveolar elasticity leads to increased residual volume. These structural changes significantly decrease the efficiency of the ventilatory pump during periods of high physiological demand. A. Changes associated with kyphosis: An exaggerated outward curvature of the thoracic spine is a common skeletal change in older adults. This postural alteration restricts lung expansion and alters the diameter of the chest. It results from age-related changes in vertebral disks and osteoporotic collapses, significantly impacting respiratory mechanics and volume. B. Increased elasticity/mobility: Aging actually results in a decrease in the elasticity of lung tissue and a reduction in chest wall mobility. The lungs become more rigid and less able to recoil during expiration. This increased stiffness increases the work of breathing and reduces the overall mechanical efficiency of the respiratory system. C. Increased vital capacity: Vital capacity, the maximum amount of air a person can expel from the lungs after maximum inhalation, decreases with age. This is due to the loss of muscle strength in the diaphragm and intercostals, combined with increased stiffness of the thoracic cage. Residual volume increases while vital capacity declines. D. Increased dyspnea on exertion: Due to decreased pulmonary reserve and reduced surface area for gas exchange, older adults experience shortness of breath more readily during physical activity. The respiratory system cannot meet the increased oxygen demands as efficiently as in younger years. This is a typical finding in the aging population. E. Decreased risk of lung infection: The risk of lung infection, such as pneumonia, actually increases in older adults due to a less effective cough reflex and decreased ciliary action. Reduced immune response and diminished clearance of secretions make the geriatric population more vulnerable to respiratory pathogens. This choice is medically inaccurate.