In this chapter, we focused on the pathogenic mechanisms leading to pneumonia in older individuals. Aging is associated with important changes in respiratory mechanics (decreased compliance of the respiratory system and strength of the respiratory muscles, increased work of breathing for a given level of ventilation), which increase the vulnerability of the very old to any further aggression to the respiratory tract. Higher rates of aspiration occur in this age group, with frequently occurring risk factors such as cerebro-vascular events, or extrapyramidal disorders. Efficacy of mucociliary clearance mechanisms, including cough, tends to decrease in the very old. Aspiration of oro-pharyngeal secretions is the most important cause of LRTI: oro-pharyngeal flora is influenced by dental status and comorbidities. Increasing morbidity leads to colonization of upper airways by pathogenic micro-organisms such as GNB and S. aureus. As in younger subjects, S. pneumoniae remains the most frequently identified pathogen. Atypical organisms play a minor role in CAP or NHAP, although the contribution of C. pneumoniae may be underestimated.

Unusual organisms and alternative diagnoses must be rapidly considered and sought after in nonresolving pneumonia.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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