COPD in the elderly
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 5
Abstract
COPD is a major public health problem that affects a significant proportion of the elderly population. The prevalence of COPD in individuals 65 years of age and older was recently estimated to be 50% compared with 20% in those 40 years. Symptoms of COPD in the elderly are nonspecyfic and recognition and diagnosis are often delayed. Dyspnea and activity limitation are common symptoms, but these may be attributed to other potential abnormalities including cardiac or other lung diseases. Many elderly patients limit their activity to avoid becoming dyspneic, and assume that their dyspnea is resulting from their aging process. Those patients seek medical attention late in their disease process. Cough is another very common symptom among the elderly patients with COPD, but cough can also be caused by other diseases as well as by medications such as ACE inhibitors. The diagnosis of COPD in the elderly, like as in other patients, should be beased on history and demonstration of airway obstruction on spirometric testing. In elderly, development of these tests is very difficult, because there are contraindications and difficulties in cooperation during examination, resulting from physical impairments and/or poor cognitive abilities. In the elderly population COPD is frequently present with several comorbidites. Cardiovascular, musculosceletal (cachexia, osteoporosis) and psychological (anxiety, depression) comorbidities are very common and can complicate the course of the disease. Acute exacerbations of COPD present a risk for acute respiratory failure in the elderly patients with advanced COPD. The elderly patients are at increased risk for adverse effects associated with COPD medications. Because the elderly tend to use multiple drugs for numerous diseases, such polypharmacy may complicate disease management and increase the likelihood of drug interactions.
Authors and Affiliations
Ada Sawicka, Ewa Marcinowska-Suchowierska
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