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Considerations for managing chronic obstructive pulmonary disease in the elderly

Authors Taffet G, Donohue J, Altman P

Received 15 August 2013

Accepted for publication 30 August 2013

Published 13 December 2013 Volume 2014:9 Pages 23—30


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

George E Taffet,1 James F Donohue,2 Pablo R Altman3

1Geriatrics Section, Geriatrics and Cardiovascular Sciences, Baylor College of Medicine, The Methodist Hospital, Houston, TX, 2Pulmonary Diseases and Critical Care Medicine, University of North Carolina, Chapel Hill, NC, 3Medical Affairs, Mylan Specialty L.P., Basking Ridge, NJ, USA

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.

Keywords: chronic obstructive pulmonary disease, inhaler, device, cognition, disability, comorbidities, maintenance therapy

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