Pneumonia in older people


What is pneumonia?

Pneumonia is a condition in which there is an infection in the lung.

It can be caused by many different organisms such as bacteria, viruses, fungi and parasites, although bacteria are responsible for approximately 50% of cases. Infection usually occurs when a person breathes in these microorganisms.

Breathing corrosive chemicals or toxic gases from a fire into the stomach, can also cause pneumonia.

In some rare cases, pneumonia is contracted when bacterial colonies from infections in other parts of the body, travel to the lungs via the bloodstream.

While people of all ages can contract pneumonia, it most commonly affects older people, especially those over the age of 70.

What are the symptoms of pneumonia?

  • Coughing: The cough is dry at first but after a day or two, the person starts to cough up phlegm. (Phlegm, also known as sputum, is a mixture of saliva/spit and mucus.) This phlegm is usually yellow, rust-coloured or bloodstained.
  • Breathing difficulties: Breathing may be fast and shallow, as the infected person gasps for air. Sometimes their lips and nails turn a bluish colour due to the lack of air (known as cyanosis). It may also hurt for them to take a deep breath or to cough.
  • Pains in the chest.
  • Shivering fits and fever.
  • Cold sores: The person may experience an outbreak of cold sores caused by the herpes virus. This is a sign that the body is unable to defend itself against the virus.
  • In older people, confusion or urinary or faecal incontinence can be the first signs of a pneumonia.

If you have any of these symptoms, or notice them in anyone else, visit your doctor immediately.

Who is most at risk from contracting pneumonia?

  • Older people, especially those over the age of 70.
  • People with weak immune systems, such as people who are HIV positive or have AIDS.
  • Alcoholics and people who have had a stroke: The epiglottis is found at the top of the larynx (voice-box). When we breathe, the epiglottis opens allowing air to travel down the larynx toward the lungs. When we swallow food or drink or regurgitate (vomit) something up, the epiglottis closes to ensure that these substances don't get to the lungs. Alcohol and stroke interferes with the function of the epiglottis, which means the lungs may be contaminated with the swallowed or regurgitated substances.
  • Chronically ill, such as people with asthma or heart conditions.
  • Smokers. People who inhale second-hand smoke can be at risk also.
  • Children, especially those who are chronically ill.
  • People who have had their spleen removed.

Why are older people more at risk of contracting pneumonia?

Older people tend to be more at risk of developing pneumonia because of changes in their immune system. As they get older, their immune systems become weaker.

This is worsened if they have a chronic condition such as asthma or a heart condition.

As smoking can put people at risk, older people who smoke have probably done so for many years, increasing this risk even more.

Stroke can put people at risk of developing pneumonia and older people are more likely to have a stroke.

How is pneumonia treated?

Hospitalisation is usually required, especially for older people and those who have a weak immune system.

Bacterial pneumonia is usually treated with antibiotics.

Other treatments, such as chest physiotherapy, may also be required.

Is there a vaccine available in Ireland?

There is a vaccine available to combat pneumococcus pneumonia, which is caused by the pneumococcus bacteria.

Around 50% of all pneumonia cases are caused by bacteria. The pneumococcus bacteria is the main cause of the most typical pneumonia.

This vaccine is particularly recommended for people who have had their spleen removed. Anyone over the age of 65 is also encouraged to consider it. People with chronic illnesses such as chronic heart disease are also recommended to have this vaccination.

This vaccine may be given at the same time as the flu vaccination. You can get further details from your doctor and discuss the advisability of having this vaccine with him / her.

What can older people do to decrease the risk of contracting pneumonia?

  • Give up smoking. If you drink, do so in moderation.
  • Discuss pneumococcal vaccine with your doctor.
  • Since many cases of bacterial pneumonia occur in people who are first infected with the flu, yearly vaccinations against the flu are highly recommended.
  • If you have a long-term disease or condition, visit your doctor regularly and ensure you maintain treatment and finish any medication that is prescribed for you.




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