Guide To Pneumonia In Elderly People

If you are an older adult, you could be more at risk of developing pneumonia than a younger person.   As we age, the immune system weakens, making it easier for our lungs to become infected with harmful bacteria or viruses. 

Additionally, many older people have other pre-existing health conditions, such as chronic obstructive pulmonary disorder (COPD) or heart disease. If you have one of these conditions, you also have a greater risk of developing pneumonia. 

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Overview of pneumonia

A bacterial or viral infection causes pneumonia in the lower respiratory tract (the lungs). It can be present in one or both lungs. 

Pneumonia occurs when the lungs’ tiny air sacs, known as alveoli, fill up with mucus. As a result, breathing becomes more difficult, and you may notice other flu-like symptoms, such as fever or muscle aches. 

The early stages of pneumonia are easily mistaken for influenza. That’s why it’s important to monitor symptoms and seek medical advice sooner rather than later. 

Symptoms of pneumonia 

The initial symptoms of pneumonia are very similar to the flu. They include: 

  • Fever

  • Sore throat

  • Hoarseness 

  • Headaches 

  • Persistent cough

  • shortness of breath 

  • Chest pain due to excessive coughing

  • Body aches

Therefore, it’s easy to assume you have a cold or flu. But if these symptoms persist for too long or worsen, it would be good to see a doctor for further advice. 

If left untreated, pneumonia can worsen, especially in older adults. So with severe cases of pneumonia, you may also notice these complications: 

  • Severe breathing difficulties

  • Feeling that you cannot get enough air into your lungs

  • Chest pain—swelling in the tissue of your lungs

  • Fatigue 

Causes of pneumonia

Pneumonia is caused by an infection in the lungs, typically viral or bacterial. Some examples of bacterial infections include: 

  • Streptococcus pneumoniae

  • Chlamydia pneumoniae

  • Legionella pneumoniae, known as Legionnaires’ disease 

  • Mycoplasma pneumoniae

  • Haemophilus influenzae

Examples of viral infections include: 

  • Respiratory syncytial virus (RSV)

  • Common cold viruses

  • Influenza

  • SARS-CoV-2 (viral infection that causes COVID-19) 

These pathogens spread via respiratory droplets from coughing or sneezing. If you breathe in an infected droplet, you could get sick and develop pneumonia later.

However, some of these pathogens don’t always cause pneumonia. For example, many people infected with the flu or a cold virus don’t always develop pneumonia.  

Can you prevent pneumonia? 

It’s impossible to prevent pneumonia entirely. However, you can minimize your chances of getting it by staying up to date with pneumonia vaccines and seeking medical advice sooner rather than later when you have cold or flu-like symptoms. 

Staying on top of other pre-existing health conditions, such as COPD or heart disease, may also help reduce your risk of developing pneumonia. 

How does pneumonia affect elderly people? 

Pneumonia can affect elderly people more severely because more complications can arise due to pre-existing health conditions and weakened immune systems. Studies have also proven that the elderly are more likely to die from pneumonia than younger people.¹

Additionally, older adults with pneumonia are more likely to have a prolonged recovery. That’s because there are more potential complications involved. As a result, they could spend extended time in the hospital while waiting for their treatment to work. 

In the elderly, pneumonia symptoms can also have a quick onset. It can be life-threatening if it develops into severe pneumonia, so older adults must seek medical care quickly before it worsens. 

Unfortunately, the mortality rate for severe pneumonia is significantly higher by 20% for elderly people compared to younger people. So again, this reinforces that medical advice and treatment are essential for older people with pneumonia.¹

Lastly, the leading cause of death in the elderly with pneumonia is respiratory insufficiency, also known as respiratory failure. When this occurs, oxygen exchange from the lungs to the blood is significantly reduced, or too much carbon dioxide remains in the blood (sometimes it can be both). 

Symptoms of respiratory failure include:

  • Shortness of breath

  • The feeling that you cannot get enough air into your lungs

  • Blue fingernails, lips, or skin 

  • Rapid breathing due to high carbon dioxide concentrations in the blood

  • Confusion 

  • Sleepiness

  • Loss of consciousness 

  • Irregular heartbeat 

If you notice these symptoms, please seek medical care urgently. 

Why are elderly people more at risk? 

Older adults are more at risk of developing pneumonia for these reasons: 

  • Weakened immune systems increase the chance of a lung infection 

  • Having a weakened immune system also makes it harder to fight an infection, even with treatment

  • Pre-existing health conditions, such as COPD or heart disease, can complicate pneumonia and make it more severe 

  • Age is a risk factor for pneumonia, and older people are more likely to develop it 

Treatment options 

Some older adults may need to be hospitalized when they develop pneumonia, especially those with severe cases. That’s because they will require specialized treatment for pneumonia and other health problems that could exacerbate when they become ill. 

Below are the treatment options for pneumonia:


The standard treatment for pneumonia is antibiotics or antiviral medications. The medicine you receive will depend on the type of infection you have. 

But ensure that your doctor knows which medications you are currently taking before you start antibiotics or antiviral treatments. That’s because some antibiotics have the potential to interact with other medicines, and this could make your condition worse. 

If you can’t remember the names of your medications, you should take your pill bottles with you to the doctor or the hospital. That way, they will know the dose and the type of medication you are taking. 

Additionally, older adults could be more prone to experiencing side effects from their medication. If that occurs, speak to your doctor for further advice. 

Other possible treatments that doctors may administer for severe cases of pneumonia are: 

  • Bronchodilators (inhalers that relax the vessels in your lungs, making it easier to breathe)²

  • Corticosteroids (inhalers with long-acting bronchodilators)³

  • Oxygen therapy (for severe cases)⁴

  • Phosphodiesterase-4 inhibitors (reduced inflammation in the airways)⁵

  • Theophylline (second-line treatment to ease chest tightness and shortness of breath)⁶

Home remedies that can help relieve symptoms 

If you are looking for additional support, some home remedies may help, such as:

  • Hot beverages like tea 

  • Soup 

  • Cough syrup 

  • Lozenges 

  • Electrolytes to stay hydrated

  • Extra pillows while sleeping to elevate the head above the chest (may improve breathing)

What’s the recovery outlook for pneumonia in elderly people? 

Pneumonia can be life-threatening; it is one of the top ten leading causes of death in the U.S. and the top cause of death from infectious diseases. With early intervention and adequate treatment, there is a good chance that you will recover from it. 

However, the recovery could take longer in older people. The recovery outlook also depends on pre-existing health conditions and how strong your immune system is. 

The lowdown

Unfortunately, the elderly are more susceptible to pneumonia, and more complications are involved. Therefore, it's essential to seek medical advice and treatment early, as this could reduce your recovery period and may reduce the severity of the disease.

Frequently asked questions 

How serious is pneumonia for the elderly?

When left untreated, pneumonia can be life-threatening for older adults. People over 65 years have a greater risk of experiencing severe pneumonia due to other health complications and weakened immune systems. 

Can an older adult recover from pneumonia?

Pneumonia in older adults can be pretty severe or life-threatening. However, recovering from pneumonia is possible, especially when they seek medical advice and treatment earlier rather than later. 

How is pneumonia treated in the elderly?

Pneumonia is typically treated with antibiotics or antiviral medication. Other medications, such as over-the-counter anti-inflammatories and pain relievers, can help by providing temporary relief from symptoms. If these treatments do not interfere with other drugs or pre-existing health conditions, a doctor will most likely prescribe these to an older adult too.

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