COPD in people over 65
COPD (chronic bronchitis and emphysema)
Because COPD and Emphysema are slowly progressive conditions, they are more common in older people, especially those with a significant smoking history.
- Stopping smoking, even in later life, is likely to improve life expectancy and slow the rate of decline of lung function.
- The conditions can be under-diagnosed and under-treated and may present late, as older people may not perceive the feeling of breathlessness so well, and may just believe that breathlessness is a normal consequence of ageing; alternatively, the presentation may not be typical, as they may experience breathlessness at night, rather than wheeze.
- With moderate to severe disease, there is an increased energy output, and people thus affected require an increased calorie intake (by at least 50%) in the form of carbohydrate and fat.
- Poor nutrition is more likely to occur in the elderly, (because of isolation, mobility problems, reduced cognitive function, or communication problems, for example). The elderly therefore, are likely to be more severely affected than a younger person, and more at risk of deterioration in their general condition.
- The adverse side effects that may occur with the use of steroids are of even more relevance in the elderly; for example, they may easily become confused or even psychotic, and if they already have existing osteoporosis, it could be worsened, and there may be an increased risk of fracture of the hip.
- The treatment in the elderly is the same.
Emphysema
- Inadequate assessment of a person’s emphysema, which may occur as a result of his/ her reduced cognitive function, or communication problems, may lead to their not receiving adequate and appropriate treatment, such as long- term oxygen therapy.
- Pulmonary rehabilitation, which involves a multidisciplinary approach, aims to improve functional capacity as much as possible, especially in the elderly, who are particularly likely to benefit from a programme of exercise, oxygen therapy, improved nutrition, and information about their condition.
