title: Treatment of chronic obstructive pulmonary disease in hospitalized geriatric patients.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease (COPD) is frequent in older subjects due to deterioration of pulmonary function and lifelong exposure to risk factors. Furthermore, COPD is often underreported because of the gradual onset of symptoms and reduced perception of symptoms in the elderly. There is thus a risk of undertreatment of COPD in older subjects.
  
  
  METHODS
  We retrospectively analyzed dossiers of 229 hospitalized geriatric patients with COPD, complete assessment datasets and successful lung function tests.
  
  
  RESULTS
  The sample comprised 78 men (38 %; mean age 77 ± 7 years) and 151 women (66 %; mean age 81 ± 6 years). The number of untreated patients decreased from 68 (28 %) at admission to 35 (14 %) at discharge (p < 0.01). Absence of treatment was associated with severity of disease: mild COPD was less likely to be treated. During the hospital stay, the prescription of metered dose inhalers (MDIs) decreased and the prescription of nebulizers increased, most likely due to the coordination problems associated with using inhalers.
  
  
  CONCLUSIONS
  Undertreatment of COPD is frequent among hospitalized geriatric patients. There is a need for adaption of current guidelines to the needs of older patients with frailty or cognitive impairment.
authors.affiliation: Zentrum für Altersmedizin, Kliniken Essen Mitte, Am Deimelsberg 34a, Essen, Germany, JCShlitzer@aol.com.
authors.forename: J
authors.initials: J
authors.lastname: Schlitzer
authors.forename: S
authors.initials: S
authors.lastname: Haubaum
authors.forename: H
authors.initials: H
authors.lastname: Frohnhofen
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D018680:Cholinergic Antagonists / Q000008:administration & dosage; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D015577:Geriatric Assessment; D005858:Germany; D006760:Hospitalization; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D012189:Retrospective Studies; D014797:Vital Capacity / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents; D018680:Cholinergic Antagonists