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Alpha-1 antitrypsin (AAT) deficiency is a genetic condition that can lead to various health problems, most notably lung diseases such as emphysema and chronic obstructive pulmonary disease (COPD). The reason adults over 50 years are particularly susceptible to lung disease related to AAT deficiency is primarily due to the cumulative effects of environmental exposures and the natural aging process which affects lung function over time.

Individuals with AAT deficiency do not produce enough of the protein that protects the lungs from damage caused by enzymatic actions of neutrophil elastase. As a result, the risk of developing emphysema or other pulmonary conditions increases significantly in these individuals as they age, particularly after the age of 50, when lung function typically starts to decline. Moreover, the onset of lung disease can be exacerbated by lifestyle factors such as smoking or occupational hazards, which adds to the susceptibility of older adults.

Younger populations, including children under 5 years and infants, may have the AAT deficiency, but they typically do not develop significant lung disease until much later in life. Young adults also might show signs of AAT deficiency, but it's less common for them to have severe lung disease compared to the older demographic. Therefore, adults