Pneumonia in old age

What is pneumonia

Pneumonia is inflammation of the air sacs in one or both lungs. It is usually caused by bacteria or viruses. The germs may be breathed into other parts of the lungs also.

Why pneumonia is important

Older adults > 65 years have a weakened immune system. Pneumonia can be severe in this age group and can lead to detrimental outcomes. The mortality ranges from 5% to 14% in the community and 30% in hospital admissions. 1 in 5 returns to the hospital with unresolving symptoms within a fortnight.

What are the symptoms of pneumonia?

The classical symptoms are fever, cough, breathlessness, which will not be present in older adults. It may present as any of

• Excessive fatigue and sleep
• Increased urination or retention
• Nausea and vomiting
• Experiencing a confusional state called delirium
• Falls
• A decline from the previous functional status and mobility
• Loss of appetite
• Worsening of existing chronic medical conditions like kidney and heart disease
Since the classic symptoms are not present, this might lead to a delay in diagnosis and treatment, hence the prognosis also.

How pneumonia is diagnosed and treated?

After a short clinical examination, order a complete blood test to look at the counts and your kidney functions. Pulse oximetry, if you are having abnormal values, an arterial blood gas may be ordered. A chest x-ray to look at the focus and any fluid collections. If your symptoms are prolonged you might need a chest CT scan. Sputum culture to look at the sensitivity of the organism. If you have fluid in the lungs, it may be aspirated and sent for culture also.

How can one prevent pneumonia?

One can avoid getting pneumonia by staying in good general health, stopping smoking, and limiting alcohol in moderation.
Another way to prevent pneumonia is vaccinations for both flu and pneumonia.
Prevention is better than cure, so lead a life with healthy habits, get vaccinated, and age in a healthy manner.

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