RESPIRATORY

SYSTEM

BARBA, KRISTINE JOY V.

 RESPIRATORY DISEASES
COMMON IN OLDER PEOPLE
Age-related changes in the • ASTHMA
lungs, years of exposure to air • CORONARY OBSTRUCTIVE
pollutants and cigarette smoke, PULMONARY DISEASE (COPD)
and the presence of • TUBERCULOSIS
comorbidities may predispose • LUNG CANCER
the older person to respiratory • RESPIRATORY INFECTION
• ACUTE BRONCHITIS
diseases and pulmonary
• PULMONARY EMBOLISM
dysfunction. The following
• SEVERE ACUTE RESPIRATORY
diseases are commonly
SYNDROME (SARS)
diagnosed pulmonary diseases
 What is Asthma?
Asthma is a chronic respiratory disease characterized by usually
reversible airflow obstruction, airway inflammation, increased mucous
secretion production, and increased airway responsiveness
(contraction of airway smooth muscles) to a variety of stimuli.
Asthma is often overlooked in the older person and can present as a
newly diagnosed disease or as a chronic disease that the older
person has lived with for many years. Undiagnosed and untreated
asthma in the older person detracts from quality of life and
contributes to frailty. In older patients, complete reversibility of
airflow problems becomes more difficult, especially in those patients
with severe and persistent problems, because of the irreversible
damage done to the airways by years of inflammatory changes and
 Asthma
With asthma, inflamed airways are characterized as “twitchy” and
overreact to common irritants like viruses, cigarette smoke, cold air,
and allergens. These triggers can activate an inflammatory response
including mobilization of mast cells, eosinophils, macrophages, and T
lymphocytes. With these inflammatory changes, airway smooth
muscle contracts, swells, and produces excessive mucous secretions.
With this airway narrowing and inflammation, it becomes difficult for
the older person to breathe.
SYMPTOMS These symptoms occur or
Common symptoms worsen when the older person
0 • Coughing—may be
0 experiences:
1 worse at night or 2 • Physical exercise
early in the morning. • Viral infection
• Wheezing—usually • Inhaled allergens (animal fur,
high-pitched whistling mold, pollen, dust mites,
sounds on expiration cockroach or mouse
• Shortness of breath excrement)
• Chest tightness • Stress and/or strong
• Nighttime waking due emotional expression
to asthma symptoms. (laughing or crying)
• Irritants (tobacco or wood
 Asthma
Mortality from asthma in older adults is reportedly increasing, but it is
difficult to define the cause of death in many older people with lung
diseases. In 2011, approximately 18.7 million Americans, including 2.6
million older adults, had been diagnosed with asthma. In 2011, more than
1 million older adults had an asthma attack or episode (Centers for
Disease Control and Prevention [CDC], 2011d). Every year, asthma puts
nearly half a million people in the hospital and kills an estimated 3,500
(CDC, 2011d).

When asthma is diagnosed in an older person, other lung and

cardiovascular diseases must be eliminated. It is sometimes difficult to
distinguish between exacerbations of chronic bronchitis, chronic
 RISK FACTORS
• Smoking: Both active smoking and exposure to secondhand
smoke are major risk factors.
• Environmental Allergens: Pollen, dust mites, mold, and pet
dander can trigger asthma symptoms.
• Occupational Exposures: Long-term exposure to irritants like
chemicals, fumes, and dust in the workplace.
• Respiratory Infections: Older adults are more susceptible to
infections, which can worsen asthma.
• Comorbid Conditions: Conditions like obesity, GERD, and
cardiovascular diseases can complicate asthma management.
 DIAGNOSIS
• Medical History: Detailed history of symptoms, triggers, and
family history of asthma or allergies.
• Physical Examination: Checking for wheezing and other
signs of respiratory distress.
• Spirometry: A lung function test to measure the amount and
speed of air a person can exhale, which helps in diagnosing
asthma and differentiate it from other conditions
• Bronchodilator Response: Testing lung function before and
after using a bronchodilator to see if there is an
improvement, which is indicative of asthma
 MANAGEMENT
Avoiding Triggers - Identifying and avoiding triggers such as
allergens, smoke, and air pollution is crucial.

Medication - Proper use of asthma medications, including inhalers

and possibly oral medications, is essential. It's important to monitor
for side effects, as older adults may be more susceptible.
• Inhaled Corticosteroids: To reduce inflammation in the airways.
• Bronchodilators: To relax the muscles around the airways and
make breathing easier.
• Combination Inhalers: Containing both corticosteroids and
bronchodilators for better control
 MANAGEMENT
Lifestyle Adjustments - Maintaining a healthy lifestyle,
including regular exercise and avoiding smoking, can help
manage symptoms.

Proper Inhaler Technique – Ensuring correct use of inhalers,

possibly with the help of spacers

Regular Monitoring – Keeping track of symptoms and lung

function to adjust treatment as needed
 IMPACT ON DAILY LIFE
• Physical Activity: Symptoms like shortness of breath and
fatigue can limit physical activities, leading to decreased
mobility and independence.

• Sleep Quality: Nighttime asthma symptoms can disrupt

sleep, leading to daytime fatigue and reduced quality of
life.

• Mental Health: Chronic conditions like asthma can

contribute to anxiety and depression, especially if
 COMORBIDITIES
• Cardiovascular Disease: Conditions like hypertension and
heart disease can interact with asthma, making
management more complex.

• Diabetes: Some asthma medications, particularly

corticosteroids, can affect blood sugar levels, complicating
diabetes management.

• Osteoporosis: Long-term use of corticosteroids can increase

the risk of osteoporosis, which is already a concern for older
MEDICATION MANAGEMENT
• Polypharmacy: Older adults often take multiple
medications, increasing the risk of drug interactions and
side effects.

• Inhaler Technique: Ensuring correct inhaler technique is

essential for effective asthma control. Older adults may
need additional training or devices like spacers to use
inhalers correctly.

• Adherence: Adherence to medication regimens can be

 ENVIRONMENTAL CONTROL

• Indoor Air Quality: Ensuring good indoor air quality by

reducing exposure to dust, mold, pet dander, and smoke
can help manage asthma symptoms.

• Seasonal Allergies: Older adults with asthma may also have

allergies that can exacerbate symptoms. Managing these
allergies through medications or lifestyle changes is
important.
 SUPPORT SYSTEMS
• Caregivers: Family members or caregivers can assist with
medication management, monitoring symptoms, and ensuring
follow-up appointments.

• Healthcare Providers: Regular check-ups with healthcare

providers are essential for monitoring asthma control and
adjusting treatment plans as needed.

• Community Resources: Support groups and community

resources can provide additional support and education for
EMERGENCY PREPAREDNESS

• Action Plan: Having a written asthma action plan can help

older adults and their caregivers recognize and respond to
worsening symptoms promptly.

• Emergency Contacts: Keeping a list of emergency contacts

and knowing when to seek medical help can prevent severe
asthma attacks.
What is Chronic Obstructive
Pulmonary Disease (COPD)?
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung
disease characterized by persistent respiratory symptoms and airflow
limitation due to airway and/or alveolar abnormalities, usually caused
by significant exposure to noxious particles or gases.

Chronic obstructive pulmonary disease (COPD) is a term used for two

closely related diseases of the respiratory system: chronic bronchitis
and emphysema. Chronic bronchitis is defined as cough and sputum
production present on most days for a minimum of 3 months for at
least 2 successive years or for 6 months during 1 year.
 Chronic Obstructive
Pulmonary Disease (COPD)
In chronic bronchitis, there may be narrowing of the large and small
airways, making it more difficult to move air in and out of the lungs.

In emphysema, there is permanent destruction of the alveoli, the tiny

elastic air sacs of the lung, because of irreversible destruction of
elastin, a protein in the lung that is important for maintaining the
strength of the alveolar walls.
 SYMPTOMS
• Shortness of breath, especially during physical activities
• Chronic cough with mucus production
• Wheezing
• Chest tightness
• Frequent respiratory infections
• Fatigue
• Unintended weight loss in later stages
 SYMPTOMS
The earliest presenting symptom of COPD is early morning
cough with the production of clear sputum. The sputum will
turn to yellow or green should the older person develop a
respiratory infection. Periods of wheezing may occur during or
after colds. Shortness of breath on exertion develops later and
becomes more pronounced with severe episodes of dyspnea
occurring during even modest activity like walking or making
a bed.
 PREVALENCE AND RISK
FACTORS
• Prevalence: COPD is more common in older adults,
particularly those over 65. It often develops after years of
exposure to risk factors.

• Risk Factors: The primary risk factor is long-term exposure

to cigarette smoke. Other factors include exposure to air
pollutants, occupational dust and chemicals, and a history
of respiratory infections.
 DIAGNOSIS
• Spirometry: Measures lung function and airflow limitation

• Chest X-ray or CT scan: Identifies lung damage and other

issues

• Arterial blood gas analysis: Assesses oxygen and carbon

dioxide levels in the blood

• Blood tests: To rule out other conditions and check for

genetic factors
 MANAGEMENT
Managing patients with COPD focuses on the following broad
goals:

• Careful assessment and monitoring of the treatment of the

disease
• Reducing risk factors (cigarette smoking and
environ[1]mental pollutants)
• Managing stable COPD and preventing disease progression
• Assessing and managing anxiety and depression
• Mucolytic therapy
• Rehabilitation
 MANAGEMENT
Managing COPD in older adults involves:
• Medications: Bronchodilators and inhaled corticosteroids are commonly
used to manage symptoms and reduce exacerbations.

• Oxygen Therapy: For those with severe COPD, supplemental oxygen

may be necessary.

• Pulmonary Rehabilitation: This includes exercise training, nutritional

advice, and education to help manage the disease.

• Lifestyle Changes: Quitting smoking, avoiding lung irritants, and

maintaining a healthy diet and exercise routine are crucial.
 COMPLICATION
Older adults with COPD are at higher risk for
complications such as:

• Respiratory infections like pneumonia

• Heart problems
• Lung cancer
• Depression and anxiety due to chronic illness.
Thank
you!