title: Considerations for managing chronic obstructive pulmonary disease in the elderly.
abstract: Chronic obstructive pulmonary disease (COPD) is common in older people, with an estimated prevalence of 10% in the US population aged ≥75 years. Inhaled medications are the cornerstone of treatment for COPD and are typically administered by one of three types of devices, ie, pressurized metered dose inhalers, dry powder inhalers, and nebulizers. However, age-related pulmonary changes may negatively influence the delivery of inhaled medications to the small airways. In addition, physical and cognitive impairment, which are common in elderly patients with COPD, pose special challenges to the use of handheld inhalers in the elderly. Health care providers must take time to train patients to use handheld inhalers and must also check that patients are using them correctly on a regular basis. Nebulizers should be considered for patients unable to use handheld inhalers properly. What follows is a review of issues associated with COPD and its treatment in the elderly patient.
authors.affiliation: Geriatrics Section, Geriatrics and Cardiovascular Sciences, Baylor College of Medicine, The Methodist Hospital, Houston, TX.
authors.forename: George E
authors.initials: GE
authors.lastname: Taffet
authors.affiliation: Pulmonary Diseases and Critical Care Medicine, University of North Carolina, Chapel Hill, NC.
authors.forename: James F
authors.initials: JF
authors.lastname: Donohue
authors.affiliation: Medical Affairs, Mylan Specialty L.P., Basking Ridge, NJ, USA.
authors.forename: Pablo R
authors.initials: PR
authors.lastname: Altman
mesh_terms: D000280:Administration, Inhalation; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy*; D012137:Respiratory System / Q000503:physiopathology
chemical_list: D001993:Bronchodilator Agents
keywords: chronic obstructive pulmonary disease; cognition; comorbidities; device; disability; inhaler; maintenance therapy