[Community acquired pneumonia in the elderly].Rev Prat. 2003 Sep 15; 53(13):1434-41.RP
Pneumonia, more frequent in the elderly, results in higher morbidity and mortality, and is a frequent cause of hospitalisation. Although the incidence of pneumonia increases with age, mainly after 70-75 years, life in institution, comorbid medical illness (heart disease, chronic obstructive pulmonary disease, dementia), malnutrition and defence impairments are independent risk factors. Older patients with pneumonia complain of significantly fewer symptoms than younger patients. Streptococcus pneumonia is the most common cause of pneumonia, atypical pathogen are rare. There is a shift toward gram-negative bacteria and opportunistic flora with increasing age and severity of concomitant medical illness. Anaerobic bacteria are frequent in aspiration pneumonia. To hospitalize or not is the first decision to take, based on clinical criteria and risks factors. Use of the guidelines for empirical treatment of pneumonia is recommended. Old patients often recover slowly. Pneumococcal and influenza vaccinations are effective and warranted.