Pneumonia is the inflammation of the tissue in the lungs and typically occurs due to an infection. In people ages 65 years and older, pneumonia may become serious due to the higher risk of developing complications.
According to the American Lung Association (ALA), older adults have a higher risk of developing a severe illness related to pneumonia. This is because their immune systems become less able to fight off the disease.
Pneumonia can develop suddenly over 1 to 2 days or come on slowly over several days.
This article explores pneumonia in older adults in more detail, including when to seek emergency help, symptoms, recovery, and risk factors.
Typical symptoms of pneumonia include:
However, these typical symptoms are unclear in older adults and may not present fully.
The ALA notes that older adults may present with fewer and milder symptoms and perhaps an atypically lower temperature.
Symptoms of pneumonia in older adults may include:
- coordination issues, which may cause falls
- sudden change in day-to-day functioning
- reduced appetite
- incontinence
- confusion
- delirium
Bacterial pneumonia
Bacterial pneumonia is the most common form of the condition and can be more serious.
Symptoms can develop suddenly or gradually. These symptoms include:
- a fever that can reach high temperatures, such as 105°F (40.5°C)
- sweating
- increased breathing and pulse rate
- bluish or discolored lips and nailbeds
- confusion
Viral pneumonia
Viral pneumonia symptoms develop over several days. Initially, a person may experience:
- fever
- dry cough
- headache
- muscle pain
- muscle weakness
After 1 to 2 days, symptoms worsen, and a person may experience:
- increased coughing
- shortness of breath
- muscle pain
- high fever
- blue lips
Pneumonia can quickly become serious for older adults.
If a person suspects they or an older relative may have pneumonia, they need to seek immediate medical advice.
If symptoms are severe or do not improve, an older adult may need to go to the hospital.
People should immediately contact emergency services if they experience:
- breathing difficulties
- a blue or discolored face or lips
- coughing up blood
- chest pain
- a high fever
- severe cough with mucus
- sweating and feeling cold, with paler, discolored, or blotchy skin
- fainting or collapsing
- drowsiness or confusion
- a rash that does not fade after rolling a glass over it
In most cases, people with pneumonia can treat their symptoms at home by:
A person needs to avoid taking cough medication unless a doctor recommends this course of action.
If the cause of the pneumonia is bacterial, a doctor will prescribe antibiotics. People must complete the whole course of antibiotics even if they feel better, as stopping early could trigger the infection again.
If an older adult requires hospitalization due to pneumonia, they may need oxygen therapy, as well as an IV drip to receive fluids via a vein.
Recovery from pneumonia in older adults can be a long process. According to a 2017 article, although some older adults recover in 6 weeks, it may take as long as 12 weeks for others.
It is important to rest for as long as possible during recovery.
The British Lung Foundation suggests the following recovery timeline:
| Length of time | What to expect |
|---|---|
| 1 week | The fever should have resolved. |
| 4 weeks | The chest will feel better, and a person will produce less mucus. |
| 6 weeks | A person will cough less often and find it easier to breathe. |
| 3 months | Most symptoms should have gone, although people might still feel fatigue. |
| 6 months | A person may feel fine again. |
There is no sure way to prevent pneumonia. However, older adults can help reduce their likelihood of developing the condition with the following:
- Hand hygiene: A person needs to wash their hands regularly to remove any germs.
- Quit smoking: A
systematic review of tobacco smoking on developing pneumonia in the community highlights a strong association between them. This suggests those who smoke are at higher risk of the condition.
Vaccinations
The
They may only receive PCV20 or PCV21 if they have received PCV13 (at any age) or PPSV23 (at or after the age of 65 years.
The CDC recommends that adults ages 50 years or over get the following vaccines if they have an unknown vaccine history or have not received a pneumococcal vaccine:
- PCV15
- PCV20
- PCV21
If a person receives PCV15, they may receive a dose of PPSV23 after 1 year. However, this is unnecessary with PCV20 and PCV21.
Sometimes, older adults develop pneumonia following a hospital stay. In these cases, a healthcare professional may refer to it as hospital-acquired pneumonia.
However, people can also acquire pneumonia in the community, and individuals may refer to this as community-acquired pneumonia.
Causes of pneumonia include:
- Bacteria: Pneumococcal pneumonia is the most common type of bacterial pneumonia. It can develop after a person has a viral cold or the flu.
- Viruses: The influenza virus is a common cause of viral pneumonia. The virus enters the lungs and multiplies.
- Fungi: Fungal pneumonia occurs when people are exposed to fungi from bird droppings or contaminated soil.
As well as age, other risk factors of pneumonia
Older adults have a higher risk of developing complications from pneumonia. Examples of these include:
- Pleurisy: This condition involves inflammation of the pleura in the lungs. The pleura are the two large layers of tissue that separate the lungs from the chest wall. Pleurisy can cause respiratory failure.
- Lung abscess: This is when the tissue of the lung dies and pus develops in the resulting space. This is a rare complication and may occur in people who have a history of alcohol misuse or preexisting serious illnesses.
- Sepsis: With pneumonia, the infection in the lungs may trigger a potentially life threatening immune response called sepsis in other parts of the body.
- Acute respiratory distress syndrome (ARDS): ARDS is a severe form of respiratory failure.
Pneumonia is an inflammation of the lungs that may occur due to viral, bacterial, or fungal infections.
Older adults are more likely to develop complications of severe pneumonia. If a person suspects they have pneumonia, they need to seek immediate medical help.
Early treatment increases the likelihood of recovery and reduces the risk of complications.
Q:
What is the outlook for those over the age of 65 with pneumonia?
A:
The incidence of community-acquired pneumonia in older adults is about four times higher than in the general population. Often, they will require hospitalization and supplemental oxygen. This helps improve some major outcomes, including the length of stay or the need for invasive procedures such as mechanical ventilation.
Mortality is higher among the elderly, and age is an independent risk factor. Comorbidities may contribute to worse outcomes, particularly with underlying lung disease or malignancy.
Michael Virata, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.