Pneumonia in the elderly.

The organisms to which the elderly are most susceptible are different from those affecting younger pneumonia patients. Furthermore, the pathogenesis of the disease varies with age, partly because of an increased incidence of underlying disease in older persons and partly because of the effects of the aging process itself. Presenting symptoms of pneumonia may be more subtle in the elderly than in younger patients, and clinical findings may also vary. Elderly pneumonia patients should always be hospitalized and treated immediately and aggressively with parenteral antibiotics according to results of the Gram stain. Once the pathogen involved is identified, more specific antibiotic therapy is begun. If physicians understand the unique characteristics of pneumonia in the elderly and act accordingly, they should play an important part in decreasing the relatively high mortality from the disease in this age-group.