How to Manage COPD in Elderly

Chronic Obstructive Pulmonary Disease (COPD), a common illness in the elderly, is a major cause of chronic morbidity and mortality. COPD is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response to the presence of noxious particles or gases in the airways and lungs. Exacerbations and comorbidities contribute to the overall severity in individual patients.

COPD is common in older people, with an estimated prevalence of 10% in population aged ≥75 years. Inhaled medications are the cornerstone of treatment for COPD and are typically administered by one of three types of devices, i.e. pressurized metered dose inhalers, dry powder inhalers, and nebulizers. However, age-related pulmonary changes may negatively influence the delivery of inhaled medications to the small airways. Also, physical and cognitive impairment, which are common in elders with COPD, pose special challenges to the use of handheld inhalers in the elderly. Health care providers must take time to train patients to use handheld inhalers and must also check that patients are using them correctly on a regular basis. Nebulizers should be considered for patients unable to use handheld inhalers properly.

COPD causes progressive damage to a person’s lungs. The airways of the lungs become obstructed, making it hard to breathe. Dying of COPD is dying of shortness of breath, one breath at a time. The rest of the body wears out. In other words, COPD can lead to other comorbid conditions such as heart disease.


Causes COPD in Elderly

The main cause of COPD is tobacco smoking. COPD often occurs in people exposed to fumes from burning fuel for cooking and heating in poorly ventilated homes. Only about 20 to 30 percent of chronic smokers may develop clinically apparent COPD, although many smokers with long smoking histories may develop reduced lung function. Some smokers develop less common lung conditions. They may be misdiagnosed as having COPD until a more thorough evaluation is performed.