Chronic obstructive pulmonary disease in the elderly: an update on pharmacological management.

The prevalence of chronic obstructive pulmonary disease (COPD) continues to rise in association with an aging Western society. While barriers to receiving optimal healthcare exist for aging patients, pharmacotherapy of COPD in the elderly is important because the treatment benefits in this group are comparable to those seen in the younger COPD population. The frequent presence of co-morbidities and reduced clearance capacity make selection of pharmacotherapy in elderly patients with stable COPD challenging. The adverse effects of standard therapy for COPD may also be more pronounced in elderly patients. A careful risk-versus-benefit assessment should always be carried out when prescribing long-term inhaled bronchodilator and corticosteroid therapy to an elderly COPD patient, and when prescribing beta(2)-adrenoceptor agonists and methylxanthines, in particular, to those with cardiovascular co-morbidities. The present review focuses on the special considerations regarding initiation and maintenance of pharmacotherapy in elderly patients with stable COPD.