COPD in Elderly Patients: Here is What to Expect

Elderly patients experience some additional challenges when it comes to chronic obstructive pulmonary disease (COPD). The disease process of COPD brings new obstacles with breathing and maintaining normal oxygen levels. However, additional issues with aging like deconditioning and malnutrition also play a significant role in the overall management of the disease.

In this blog post, we will discuss the various challenges that arise in COPD with elderly patients. If you suffer from COPD yourself, we will also discuss some ways to improve your disease management as you advance in age.

Physical and Cognitive Limitations

As we age, our bodies change in many ways, and those changes create new physical challenges. There are 4 age-related developments that can affect the way COPD is treated in elderly patients:

1. Reduced Muscle Strength and Coordination
Sarcopenia, or the loss of muscle tissue due to aging, directly affects physical activities such as exercise and breathing. Your body uses muscle power to generate each breath via your diaphragm and accessory muscles, so any loss of muscle strength will affect your ability to maintain sufficient oxygen levels during activity.
Loss of coordination is also a common result of aging. If this occurs, you might find it difficult to perform certain exercises or to use your breathing medication devices. Some breathing medications have particular methods to get the right dose, and fine motor skills are a critical prerequisite.

2. Rigid Blood Vessels
As we age, our blood vessels become less pliable and more rigid. When this happens, your heart has to pump harder to send blood through the blood vessels. This can put a strain on your heart, which might lead to additional cardiac and respiratory issues.

3. Changes in Memory and Cognition
Some elderly patients also experience memory and cognition problems, which makes it challenging to remember medication schedules and how to use certain medications like inhaled steroids or dry-powder inhalers. These types of medicines require a certain level of skill to be used properly, so any sort of mental impairment can affect the treatment plan.

4. Lung Cell Changes
As we age, most of us will experience some degree of cell changes to our lungs. While not everyone will experience symptoms from these cell changes or be diagnosed with COPD, these regular changes can further affect things like inflammation and lung elasticity (the stretchability of your lungs).

Medication Side Effects

Respiratory medications used in the treatment of COPD do not come without their side effects. These side effects often create new challenges for concurrent diseases like congestive heart failure or diabetes. Although these medications are necessary for many people, there are a few things to consider:

Bronchodilators
Bronchodilators, also known as “rescue inhalers,” are used to open your airways during an acute COPD exacerbation. These medications are indispensable in most cases, but they can also increase your heart rate. If you also have an underlying heart condition, your doctor might take steps to mitigate the adverse cardiac side effects of bronchodilators by using other medications or changing the concentration of your regular dose.

Inhaled Steroids
Inhaled steroids are considered maintenance medications because they work by preventing COPD attacks throughout the day. However, there is a list of side effects with inhaled steroids that can exacerbate common conditions found in elderly patients:

  • Candidiasis
  • Cataracts
  • Glaucoma
  • Osteoporosis
  • Increased blood sugar

Like bronchodilators, inhaled steroids are generally indispensable. However, they might need to be titrated if other diseases are present.

How to Improve Your COPD Symptoms as an Elderly Patient

If you have COPD, you can take control of your disease using a few simple strategies:

  • Increase exercise tolerance and muscle tone
  • Remind yourself about medication times
  • Get your flu and pneumococcal vaccines every year
  • Request for pulmonary rehab

The first 3 strategies on this short list are within your direct control. However, your doctor has to prescribe pulmonary rehab for you. If your insurance will pay for it, pulmonary rehab can change your outlook on life with COPD and help you take control of your illness.

Final Thoughts

Aging comes with its own set of challenges, but these challenges can be heightened if you also have COPD. That said, there are ways to manage, and even counteract, some of the adverse effects of aging so you can control the symptoms and progression of COPD.

Information on this page is for reference and educational purposes only. For more information about chronic obstructive pulmonary disease (COPD), talk to your doctor or primary care provider.

Page last updated: October 15, 2018

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About Ryan Anthony: Ryan A., BS, RRT is a registered respiratory therapist and content writer and medical blogger currently located in Los Angeles, California. As a Respiratory Therapist, he performs a wide range of hospital duties including adult and neonatal intensive care, nitric oxide therapy, high-frequency oscillatory ventilation, conventional mechanical ventilation, noninvasive ventilation, BiPAP, CPAP, intubation assistance, bronchoscopy assistance, cardiopulmonary resuscitation, chest physiotherapy, and nebulizer therapy.

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