Pneumonia in the elderly.

Cabre, Mateo

PURPOSE OF REVIEW The aim is to describe recent advances concerning pneumonia in older patients in relation to epidemiology, microbiology, and factors related to severity, treatment, and prevention. This article is a review of recent studies (2007 and 2008) on pneumonia in older people. RECENT FINDINGS The incidence of oropharyngeal dysphagia is increasing among older people. Biological markers of prognosis and severity do not normally offer additional relevant information to clinical data. Viral cause is increasingly relevant, and mixed infections are more severe and affect more old people. A new index has been developed (SMART-COP), which complements the existing Pneumonia Severity Index (PSI) and CURB-65 by improving identification of patients who require intensive care and vasopressor drugs. Reduction in antibiotic treatment duration is not associated with greater mortality or more readmissions. New developments regarding prevention of aspiration pneumonia and the utility of influenza and pneumococcal vaccines are discussed. SUMMARY Pneumonia is increasingly caused by viral pathogens, and the pneumococcal and influenza vaccines may not be as effective as was first published. Recent studies have shown that aspiration is an increasing risk factor for pneumonia among older people.