Understanding Pneumonia in Older Adults

May 14, 2024 | Ageing

Pneumonia is a common illness that affects millions of people annually. While pneumonia can occur at any age, it is most prevalent and severe in older adults – just not for the reasons, one would expect!

The following article unpacks the need-to-know essentials of pneumonia, and why it’s so prevalent among our seniors.

What is Pneumonia?

Pneumonia is an infection of the lungs, that causes inflammation and fluid build-up in the air sacs. This fluid ususally results in flu-like symptoms like coughing with phlegm, fever, chills, and breathing difficulties.

The infection can be triggered by something as mundane as inhaling airborne droplets containing bacteria or viruses, or by tiny food particles going down the wrong pipe into the lungs, and breeding bacteria.

Some forms of pneumonia are contagious, transmitted through coughing and sneezing. While others, like aspiration pneumonia, are the result of food or water caught in the lungs, are not.

Why Are Older Adults at Increased Risk?

While pneumonia can affect anyone, seniors are particularly vulnerable – and more likely to experience severe symptoms. Studies estimate nearly a million adults aged 65 and over are hospitalised due to pneumonia annually in the United States alone.

Several factors contribute to heightened risk among older individuals:

  • Weakened immune systems, making it harder to fend off infections.
  • Underlying health conditions, like cardiopulmonary diseases or diabetes, increase susceptibility.
  • Hospitalization, especially in intensive care units, can heighten exposure to pathogens.
  • Difficulty swallowing, prevalent in older adults with conditions like Parkinson’s or stroke, elevate the risk of aspiration pneumonia. (not contagious but still potentially life-threatening, if not managed.)
  • Misdiagnosis

Understanding Pneumonia Symptoms in Older Adults

Lesser known fact: The symptoms of pneumonia in older adults differ from those of other age groups.

Pneumonia symptoms are usually easily identifiable. The typical flu-like symptoms usually include a persistent cough, chills and fever. Not so with older adults. Instead they display anti-pneumonia symptoms – including confusion, disorientation, and/or a lower-than-normal body temperature. Indicators of infection which are more often than not, overlooked.
These unusual and atypical symptoms, make diagnosing pneumonia in older adults significantly more challenging, leading to delays in treatment.

Typical symptoms associated with Pneumonia in older adults include:

  • Absence of fever or below-normal body temperature
  • Confusion or delirium
  • Sudden changes in competancies and daily functional abilities,
  • Chest pain, specifically during breathing or coughing
  • Weakness or instability
  • Urinary incontinence
  • Loss of appetite
  • Exacerbation of existing health conditions
  • Excessive Fatigue

 

When to Seek Medical Attention?

Awareness and early detection is crucial for effective intervention, especially amidst an age-group with so many underlying vulnerabilities. Without medical intervention pneumonia can rapidly escalate.

Pay careful attention to the following early signs of the need for medical attention:

  • Difficulty breathing
  • Bluish discoloration of nails, face, or lips (when not cold)
  • Chest pain
  • Abnormal body temperature (high fever or lower than normal)
  • Delirium, confusion or changes in normal day to day functioning.

Treatment and Recovery

Pneumonia can become very serious, very quickly, so prompt diagnosis and treatment are imperative to prevent worsening symptoms.

Diagnosis typically involves a trip to the doctor, where chest X-rays, CT scans and blood tests are used to confirm the presence of infection in the lung and isolate the cause.

The cause will determine the treatment.
Bacterial pneumonia is most often treated with antibiotics.
But antibiotics are not effective against viruses. So Viral pneumonia usually requires increased fluid intake and over-the-counter medications that deal with the symptoms. 

Pneumonia Recovery

Early diagnosis is key to a speedy recovery. The later the diagnosis, the worse the symptoms and the longer the recovery.
Length of recovery is obviously directly proportional to the severity of the infection. Generally healthy older adults can take weeks to recuperate, while those with underlying conditions can take even longer. Severe cases may necessitate hospitalisation followed by in-home assistance. Paying particular attention to nutrition, fluid intake, rest, and managing underlying conditions is vital to recovery.

Prevention Strategies for Older Adults

To quote the old adage, prevention is better than cure. And to do that, all the usual basics apply: Maintaining a healthy immune system, good hygiene, smoking cessation, and managing chronic conditions will go a long way to building resistance. A. balanced diet, regular exercise, and adequate sleep also help keep your immune system strong, reducing vulnerability to pneumonia and safeguarding health and well-being.