Risk Factors and Complications of Pneumonia in the Elderly

Pneumonia is the leading cause of death due to infectious disease in the elderly and the 4th most common cause of death in the USA overall. Pneumonia also remains the second most frequent healthcare-acquired infection (HAI).  Statistics show the two groups most at risk are children under the age of five and in older adults over the age of 65. There are various complications that arise from pneumonia and developing in the geriatric population;;  Clostridium difficile Infection (C.diff.) which results in severe G.I.  distress with symptoms of watery stools (diarrhea) of three or more episodes within twenty-four hours. abdominal cramping, fever, nausea.

What are the symptoms of Pneumonia?

The signs and symptoms of pneumonia vary from mild to severe, depending on factors such as the type of germ causing the infection, and your age and overall health. Mild signs and symptoms often are similar to those of a cold or flu, but they last longer.

Signs and symptoms of pneumonia may include:

• Chest pain when you breathe or cough
• Confusion or changes in mental awareness (in adults age 65 and older)
• Cough, which may produce phlegm
• Fatigue
• Fever, sweating and shaking chills
• Lower than normal body temperature (in adults older than age 65 and people with weak immune systems)
• Nausea, vomiting or diarrhea
• Shortness of breath

Newborns and infants may not show any sign of the infection. Or they may vomit, have a fever and cough, appear restless or tired and without energy, or have difficulty breathing and eating.

Recent empirical evidence noted the co-occurrence of pneumonia with C.diff. among the elderly in the USA, commonly found due to the recent use of antibiotics and a C.diff. infection can develop within ninety days post-antibiotic therapy. Pneumonia misdiagnosis and inappropriate use of antimicrobial therapy to treat viral vs bacterial infections, are often associated with C.diff. outbreaks among the elderly.  In order to minimize the risk of the elderly contracting both pneumonia and the complications that relate to it, it is important to first and foremost understand  antibiotic therapy, the infection being treated and always discussing antibiotics with the healthcare providers before initiating treatment.  This course of action may prevent the elderly, who are more at risk,  of contracting this life-threatening respiratory disease and the complications that can arise.

Why is the senior population more at risk in developing pneumonia?

Frailty

Seniors are simply frailer than their younger counterparts.  Frailty, however, doesn’t boil down to a single disease or diagnosis. One study outlines the condition as a combined decline across a number of physiological systems which cause a decreased resistance to general environmental stress.  One such common marker of frailty among the elderly is muscular weakness which can directly affect an individual’s ability to clear secretions from the lungs and subsequently avoid infection. It is due to the frail nature of the elderly that it is of vital importance to have effective life saving systems in place to assist both the elderly and their caretakers in times of need.

Compromised immune systems and senior health conditions

As we age our immune systems weaken, making it harder for us to fight off infections such as pneumonia. In addition to this, some drugs such as steroids as well as chemotherapy can further suppress immune responses.  Seniors may suffer from conditions such as heart disease, Diabetes and Alzheimer’s which also puts them at a greater risk along with lung conditions such as Asthma, Chronic Obstructive Pulmonary Disease  (COPD) Cystic Fibrosis,  to name a few diagnosis that directly contribute to the elevated risk of developing Pneumonia.

Surgery

Seniors who have had surgery are more susceptible to pneumonia since their bodies are already working very hard to heal. Pain medications are often prescribed following surgical procedures but they can interfere with a patient’s breathing, causing them to take shallower breaths which in turn cause mucus to gather in the lungs.  The same applies to the use of sedative medicine and anesthesia.

Adults over the age of 65 fall into a high-risk group for both Pneumonia and acquiring a C.diff. infection and should seek medical attention as soon as any symptoms are present.  For some senior adults, especially those with underlying medical conditions such as chronic lung diseases and heart failure, pneumonia can very quickly become a life-threatening condition, underlining the importance of medical intervention as early as possible.

Article Donated by Guest Author – Lucy Wyndham

Edited by C Diff Foundation Staff Writers.

References:

https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487835/

https://www.mayoclinic.org/diseases-conditions/pneumonia/symptoms-causes/syc-20354204