Pneumonia in Older Adults: Causes, Symptoms, and Prevention

Pneumonia in Older Adults: Causes, Symptoms, and Prevention

In Malaysia, pneumonia was the second leading cause of death in 2018. Find out more about how to manage pneumonia in seniors in this article.

by Katherine Khaw

Pneumonia in Older Adults: Causes, Symptoms, and Prevention

When a person falls ill, coughing is one of the common symptoms. However, a persistent cough that drags on for weeks may be a sign of something serious, such as pneumonia. In this article, we will focus on pneumonia in older adults: understanding the possible causes, symptoms and ways to prevent it, as it can be deadly.

What is Elderly Pneumonia?

Pneumonia in Older Adults: Causes, Symptoms, and Prevention
According to the World Health Organisation (WHO),
influenza and pneumonia are the second leading causes of death in Malaysia in recent years. This is especially a cause for concern in the recent pandemic, COVID-19, which affects the respiratory system.

Pneumonia is defined as an infection that inflames the air sacs in a person’s lungs. This may affect one or both lungs. When the lungs are filled with fluid or pus, this can lead to coughing these sticky substances. Not only that, one may experience other conditions such as shortness of breath.

The elderly (alongside young children) are the most susceptible to it. This may be due to underlying health problems or weakened immune systems.

Causes of Pneumonia

Causes of Pneumonia- infection in lungsPneumonia develops when there is an infection in the small sacs of your lung. Then, this causes the lung to swell and leak fluids.

In most cases, pneumonia is caused by bacteria or fungi. These are some of the common illnesses that can lead to pneumonia: 

  • A common cold
  • COVID-19
  • Flu
  • Respiratory syncytial virus (RSV)

The causes of pneumonia can be considered from two angles: where it was contracted, and what type of germ has caused it. For instance, pneumonia can be contracted from different places, such as follows:

  • From a healthcare facility. Oftentimes, older adults who may have been to hospitals on a regular basis may be at increased risk for this kind of pneumonia. This is likely due to exposure to various people and environmental risks. In addition, pneumonia can be developed in a patient while they are being treated for another condition. Persons who are on breathing machines in intensive care are particularly susceptible to infection.
  • Through inhaling infected food, saliva or vomit into one’s lungs. This kind of pneumonia is also known as aspiration pneumonia.
  • Within one’s community. It has been estimated that it is the third most common cause of hospitalisation among the elderly.

Generally, pneumonia is usually contracted by someone who is close to them. Pneumonia itself is not contagious. However, the bacteria or virus that causes it is. For instance, COVID-19 is contagious, but not all persons infected will have pneumonia. Commonly, the germ is spread by touching infected surfaces or through coughing and sneezing. Thus, situations such as nursing homes or extended stays in hospitals can be especially dangerous for the elderly.

Symptoms of Pneumonia

The signs of pneumonia in older adults
The signs of pneumonia in older adults may be different compared to other age groups.

As such, these are some of the possible symptoms one may experience.

  • Feeling weak or dizzy, which may cause a person to fall
  • Do not have a fever or a significant body temperature change
  • Experience confusion
  • Change in the ability to perform daily activities
  • Experience difficulty in urinating
  • Undergo a lack of appetite
  • Worsening of existing health conditions

As these signs may not seem obvious as pneumonia, some older adults get diagnosed later, worsening the condition at hand. 

The usual symptoms of pneumonia may also be experienced, however:

  • Coughing that can incur phlegm
  • Fever and chills
  • Chest pain
  • Tiredness
  • Shortness of breath
  • Rapid breathing

When to See a Doctor

As pneumonia can worsen quickly in higher-risk groups such as young children and the elderly, it is necessary to detect the condition as soon as possible.

Some of these signs may require immediate attention:

  • Breathing difficulties
  • Bluish hue to your face, nails or lips
  • Chest pains
  • Abnormal body temperature (significantly lower or higher than usual)
  • Changes in functional status

Before experiencing such emergencies, it is vital to identify the closest clinic or hospital, before the time of need. This will assist in last-minute logistics that can potentially save one’s life.

Diagnosing Pneumonia

senior seeking for doctor's advice

Perhaps you or your loved one have considered going to your healthcare provider for a diagnosis of the ongoing illness. Here are some of the things to expect when seeking a diagnosis:

  • Medical history

One’s medical history will be requested in order to assess your possible conditions. Examples would be your ongoing symptoms or any existing health conditions known to you. Aside from that, your healthcare provider will also check if you are on any medications. If you are a smoker, the doctor will check on your frequency of smoking. Lastly, they will check if you have received any vaccinations.

  • Physical examination

There will also be a physical examination. Typically, they will check for blood pressure, heart rate and blood oxygen levels. They may use a stethoscope to check on your condition. With this, they would ask you to breathe in deeply, in order for them to hear crackling sounds in the lungs if any.

  • Forms of testing

Additional tests may also be required to confirm or rule out pneumonia. These tests can either check the lung for signs of infection, measure lung function or examine other fluids as well.

These tests may include:

  • Imaging, such as an X-ray or CT scan. This is taken to visualise the state of your chest and lungs.
  • A blood test would involve taking a sample from the vein in one’s arm. Results can indicate if there is an infection.
  • Sputum test, where cultures are taken. This can help to determine what type of germ could be causing the infection.
  • Pulse oximetry, where the amount of oxygen in one’s blood is measured.
  • Other tests such as arterial blood gas tests or bronchoscopy.

Seeking for diagnosis if you suspect pneumonia is extremely vital as serious complications can lead to hospitalisation. These are some of the possible complications that you may face:

  • Respiratory failure or breathing difficulties.
  • Fluid around the lungs.
  • Sepsis or organ failure.
  • Pus-filled holes in the lungs, otherwise known as lung abscesses.

Treatment for Pneumonia

Drink more fluids

senior drinking water

Treatment for pneumonia will change depending on the severity of the illness. In most cases, pneumonia can be treated by resting sufficiently. Not only that, antibiotics are prescribed if there is a bacterial infection. Generally, drinking plenty of fluids is a sure way to rejuvenate your body system. The goal of treatment is to cure the infection, in order to avoid complications.

Most people are able to manage cough and fever symptoms by the following:

  • Medication to bring down the fever
  • Drinking fluids in order to loosen and bring up phlegm
  • Drinking warm beverages, taking hot baths and using a humidifier to open up the airways for easier breathing
  • Avoiding smoke
  • Being rested

In some cases, one may be given intravenous fluids and antibiotics, alongside oxygen therapy for assistance.

Preventing Pneumonia

Pneumonia prevention
As contracting pneumonia in your older age is a risky affair, take precautions by using the following steps:

  • Get the vaccine – The pneumococcal vaccine will help to prevent pneumonia, due to S. pneumoniae. It is best to check with your healthcare provider on which vaccine is recommended for your health condition. A person with a weakened immune system or chronic health condition may qualify for this vaccine before the age of 65.
  • Get the influenza shot – As pneumonia is a complication that may occur from the flu, getting the influenza shot is a good way to reduce your risk for the disease.
  • Practise good hygiene – Frequent hand washing will help to prevent many types of infection.
  • Refrain from smoking – Smoking damages one’s lungs. Then, this would make it harder to fight infection.
  • Making healthy lifestyle choices – This can range from one’s diet, exercise frequency and getting enough sleep. Make the right choices in order to enrich and strengthen your immune system.


About the Writer
Katherine Khaw
Katherine is an avid reader, finding joy in halls of words. Aside from the imagination wandering in worlds not here, she enjoys stargazing and gardening. In her heart of hearts, she aspires to be a writer, and to be more than mere dust.
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