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Pneumonia in the Elderly

Story at-a-glance

  • Pneumonia in seniors is often asymptomatic, a result of their weakened immune response. One of the most dangerous strains for the elderly is streptococcus or pneumococcal bacteria, which accounts for 40,000 pneumonia deaths per year
  • Pneumonia in the elderly should not be taken lightly. Pneumonia caused by this bacteria strain can come on suddenly, and may lead to lung damage, bacteremia and meningitis

For healthy adults with no underlying illnesses, pneumonia is generally not a cause for alarm, as it can be treated appropriately. However, the same cannot be said for the elderly; in 2016 pneumonia was the eighth leading cause of mortality among seniors in the U.S.1 — 85 percent of all pneumonia deaths occur in persons aged 65 and older.2 But what makes elderly people more susceptible to this illness?

Why Do Seniors Become Susceptible to Pneumonia?

According to Dr. Joseph Mylotte, an internist and professor of medicine at the School of Medicine and Biomedical Sciences at the University of Buffalo, there are several reasons why seniors are more prone to pneumonia than younger populations. One reason is that they often suffer from debilitating and life-threatening conditions, such as heart disease, which make them more vulnerable to the infection.3

Elderly people also typically have a poor immune response, so their bodies do not tolerate infections as well as before.4 Pneumonia in seniors is often asymptomatic, a result of their weakened immune response.

For example, young people may develop and cough up sputum (mucus and saliva) when they have pneumonia — an unpleasant but healthy response, as it means the body is working naturally to clear up the lungs.

But the elderly tend to lose lung capacity as they age, making it difficult for them to cough productively. This causes the sputum to build up instead of being expelled.5 What’s more, elderly individuals are used to feeling sick more often, making them less likely to notice the symptoms.

The Dangers of Pneumonia in Seniors

Mylotte says that even if the infection is localized to the lung, the effects of pneumonia are widespread, and may cause life-threatening complications like kidney failure,  bacteremia (infection spreading to the bloodstream) and low blood pressure. The pus in the alveoli may also spread to implanted medical devices, such as a replaced valve or pacemaker.

There are numerous organisms that can cause pneumonia in the elderly, but the most common ones are bacteria or viruses. One of the most dangerous strains for the elderly is Streptococcus pneumoniae, which accounted for 36,000 pneumonia deaths in 2011.6 Pneumonia caused by this bacteria strain can come on suddenly, and may lead to lung damage, bacteremia and meningitis.

Certain factors can increase an elderly person’s risk for pneumonia. One is suffering from certain ailments, like diabetes,7 HIV,8 Parkinson’s disease9 or lung conditions like asthma,10 cystic fibrosis,11 bronchiectasis12 and COPD (chronic obstructive pulmonary disease).13 Other risk factors include:14,15

Alcoholism

Immunosuppression

Being over 70 years old

Staying in nursing homes

Liver or renal disease

Cancer

Pneumonia in the elderly should not be taken lightly because, again, it is deadly. In fact, the medical community considers it as severe as a heart attack. Treating pneumonia in elderly people is also tricky, as conventional medications (which can have unwanted side effects) for this illness can be difficult to administer, as the kidney and the liver’s ability to metabolize medications changes with old age.

Elderly individuals are also more sensitive to dosages and prone to effects such as stomach upset. Some seniors are also taking a cocktail of medications for other illnesses, which can interfere with or affect the way prescription drugs for pneumonia work.

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Pneumonia Causes

Pneumonia Symptoms

Pneumonia Treatment

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Pneumonia In Elderly

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Sources and References

  • 1 CDC Leading Causes of Death by Age, Table 20, 2017  
  • 2 American Lung Association November 2015
  • 3, 13 Periodontol 2000. 2007; 44: 164–177
  • 4 Aging health. 2009; 5(6): 763–774
  • 5 Clinical Microbiology and Infection, Volume 7, Issue 11, November 2001, Pages 581-588
  • 6, 15 Clinical Microbiology and Infection, Volume 20, May 2014
  • 7 J Geriatr Cardiol. 2013 Sep; 10(3): 267–271
  • 8 Curr Opin Infect Dis. 2005 Apr;18(2):165-70
  • 9 BMC Neurology, 2015, 15:104
  • 10 Am J Med. 1994 Apr;96(4):313-20
  • 11 Int J Mol Sci. 2017 Mar; 18(3): 503
  • 12 BMJ. 2007 Nov 24; 335(7629): 1089–1093
  • 14 Clinical Infectious Diseases, (2000) 31 (4): 1066-1078
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