Practical management problems of chronic obstructive pulmonary disease in the elderly:  acute exacerbations.
OBJECTIVE
Acute exacerbations of chronic obstructive pulmonary disease (ECOPDs) have numerous causes and are associated with increased mortality and hospitalization, especially in older patients. The urgent need to identify and enable timely treatment of ECOPDs is a necessity for physicians worldwide. This review will highlight the causes and optimal combinations of available treatments for such events in older populations.


RESULTS
The exact definition of exacerbations is lacking; however, it is agreed that such events are considered episodes of worsening of symptoms, leading to morbidity and death. The aging process is a consistent determinant for ECOPD events and is associated with worsening of COPD stages. The incidence of ECOPD rises across the worsening stages of COPD. Studies have shown that the frequency of exacerbations increases with age and correlated clinical outcomes are poorer than in younger patients. The risk of mortality has also been shown to be significantly higher after a hospital admission following an acute exacerbation. At the moment, the need to rapidly and correctly treat acute exacerbations is crucially important in the rapidly growing elderly population.


CONCLUSIONS
ECOPDs are extremely dangerous events for older patients with severe stages of COPD. There is an urgent need to identify risk factors, identify tolerable treatment guidelines and manage acute exacerbations in older patients with COPD.
Scientific Direction, Italian National Research Center on Aging (INRCA), Ancona, Italy. angela_abbatecola@libero.it
Angela M
AM
Abbatecola
Alessia
A
Fumagalli
Daniela
D
Bonardi
Enrico E
EE
Guffanti
D000208:Acute Disease; D000368:Aged; D000375:Aging; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors