Must-Know Facts About Pneumonia in Elderly Adults

Pneumonia is an infection of the lungs that can be serious in older adults. In the U.S., nearly 250,000 people are hospitalized with pneumonia each year, and about 50,000 die from the disease, according to the Centers for Disease Control and Prevention (CDC). Seniors are at high risk for complications and death.

Learn the facts about this potentially severe respiratory infection and how to prevent pneumonia in elderly adults. If you suspect your elderly loved one has pneumonia, see the doctor right away.

What is pneumonia?

Pneumonia is a respiratory infection that causes inflammation in the air sacs in the lungs, called alveoli. The alveoli may fill with fluid or pus, making it difficult for oxygen to flow through the bloodstream. This may cause breathing problems along with fever, chills, and other symptoms.

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Pneumonia can affect one or both lungs. When it affects both lungs, it’s called double pneumonia. The symptoms of double pneumonia aren’t different or more severe. The severity of the infection depends on age, overall health, and what caused the infection.

What are the symptoms of pneumonia?

Signs and symptoms of pneumonia may include:

• High fever
• Chills
• A productive cough with phlegm
• Shortness of breath
• Chest pain when breathing or coughing
• Fatigue

Sometimes, symptoms of pneumonia may be different in seniors. Elderly adults with pneumonia may have a low-grade fever or even a normal temperature. They may also be less alert, show signs of confusion, or experience changes in mental awareness. If you suspect your aging loved one has pneumonia, see the doctor promptly.

How serious is pneumonia in older adults?

Adults 65 and older are more susceptible to pneumonia than younger people are. Seniors with pneumonia are also at increased risk for hospitalization, complications, and death.

Pneumonia in elderly adults can often be serious and progress quickly. In fact, pneumonia is the second leading cause for hospitalization of Medicare beneficiaries, and most of the people who die from pneumonia each year are elderly adults, according to the American Lung Association (ALA). The death rate among elderly adults with severe pneumonia is as high as 20%.

Researchers and doctors don’t fully understand why pneumonia is more aggressive in seniors. They believe it has to do with the normal aging process, which weakens the immune system and decreases lung function. Older adults also often have other underlying health conditions that can make pneumonia more severe, including asthma, chronic obstructive pulmonary disease (COPD), and heart disease.

What causes pneumonia in elderly adults?

Pneumonia is caused by bacteria, viruses, fungi, and other organisms. In the U.S., pneumonia in the elderly is usually caused by bacteria or a virus.

Pneumococcal pneumonia is the most common type of bacterial pneumonia, affecting more than 900,000 Americans each year, according to the ALA. This type of pneumonia is caused by a germ called Streptococcus pneumoniae. It can occur on its own or after someone has a cold or the flu.

These groups are at increased risk for bacterial pneumonia:

• Adults 65 and older
• People with a weakened immune system
• Patients recovering from surgery
• People with other respiratory conditions or viral infections

Viruses can also cause pneumonia. The influenza virus is the most common cause of viral pneumonia in adults. Pneumonia caused by the influenza virus can be severe and even deadly, especially in people with other health conditions such as heart or lung disease.

Coronavirus disease 2019 (COVID-19) can also cause a severe type of double pneumonia that may lead to long-lasting lung damage. It may take several months to recover. Pneumonia associated with COVID-19 can sometimes be fatal, especially in high-risk populations like elderly adults. 

Complications of pneumonia in elderly adults

Older adults are at risk for complications of pneumonia, including:

• Bacteremia, a potentially fatal infection that enters the bloodstream from the lungs and can spread to other organs
• Pleurisy, an inflammation of the membrane that covers the lungs (pleura). Pleurisy may require surgery or drainage of the infected fluid in the lungs
• Lung abscess, a pus-filled cavity that can develop in the infected lung area
• Acute respiratory distress syndrome (ARDS), which occurs when pneumonia severely injures the lungs, leading to respiratory failure. ARDS may require the use of a mechanical ventilator to help with breathing

How is pneumonia treated?

Treatment for pneumonia depends on what caused it. The goal is to eliminate the infection, prevent any complications, and treat symptoms to help your aging loved one feel better.

Bacterial pneumonia is treated with antibiotics. The doctor may run tests to determine which antibiotic medicine will work best for the type of bacteria causing your parent’s pneumonia.

It’s important to take all the medicine as prescribed by the doctor, even if your loved one starts to feel better after a few days. Not taking the full course of antibiotics as prescribed can cause the infection to come back and the bacteria to become resistant to the medicine. This will make it more difficult to treat your loved one’s pneumonia.

Viral pneumonia doesn’t respond to antibiotics. If your aging relative’s pneumonia is from a virus, the doctor may prescribe antiviral medication. However, in some cases, rest and treatment to help relieve symptoms is all that’s needed.

Viral pneumonia usually heals in a few weeks, but if your loved one’s symptoms start to get worse, it’s important to see the doctor. Bacterial pneumonia is a possible complication of viral pneumonia.

Can pneumonia be treated at home?

Your loved one may receive treatment for pneumonia at home or at a hospital, depending on the severity of the disease, their age, and overall health condition.

Your senior relative may need to be hospitalized if they have other respiratory or heart conditions. They may also need to be treated at a hospital if they need help breathing or if they have severe symptoms, including:

• Confusion
• Rapid breathing
• Low blood pressure
• A very low or very fast heart rate

If your loved one is recovering from pneumonia after a hospital stay and needs help with daily activities, consider a short-term stay at an assisted living community. Respite care allows you and your loved one peace of mind that someone is available 24 hours a day for assistance and immediate response if there’s an emergency.

Preventing pneumonia in older adults

You can help your aging loved one prevent pneumonia by encouraging them to follow these steps:

• Get the pneumococcal vaccine
  Talk to the doctor about what type of pneumococcal vaccine is right for your aging parent.
• Get the flu shot each year
  Pneumonia can be a secondary infection after an initial bout of influenza. People who get the flu shot have a lower risk of developing pneumonia as a complication of the flu.
• Wash handsthoroughly and often
  Especially before and after preparing food, before eating, and after using the bathroom.
• Practice good health habits
  Stay physically active, and eat a diet rich in fruits, vegetables, whole grains, and lean proteins.
• Manage chronic conditions
  Conditions can include asthma, COPD, diabetes, and more.
• Don’t smoke
  If you’re a smoker, talk to your doctor about help with quitting smoking.

Sources:

National Heart, Lung, and Blood Institute. “Pneumonia.” https://www.nhlbi.nih.gov/health-topics/pneumonia.

Centers for Disease Control and Prevention. “Pneumonia: an infection of the lungs.” https://www.cdc.gov/pneumonia/index.html.

American Lung Association. “Pneumonia.” https://www.lung.org/lung-health-diseases/lung-disease-lookup/pneumonia.

Ramirez J.A. “Overview of community-acquired pneumonia in adults.” https://www.uptodate.com/contents/overview-of-community-acquired-pneumonia-in-adults.