By Dr. Aldo Moran

As we age, our bodies change, and certain illnesses that might have felt like a "bad cold" in our younger years can become much more serious. Pneumonia is one of those conditions.

At Flagship Health, we believe that staying informed is the first step toward staying healthy. Because pneumonia is a leading cause of hospitalization for adults over 65, understanding how it develops, how to spot it, and—most importantly—how to prevent it is essential for maintaining your independence and quality of life.

What is Pneumonia and How Does it Develop?

Pneumonia is an infection that inflames the air sacs in one or both lungs. These air sacs may fill with fluid or pus, making it difficult to breathe and get enough oxygen into your bloodstream. In seniors, pneumonia often develops in a few specific ways:

• Bacterial Pneumonia: The most common form, often caused by Streptococcus pneumoniae. This is often a "secondary infection." It might start as a simple cold that weakens your defenses, allowing bacteria like Streptococcus pneumoniae to move in and multiply. In older adults, bacterial pneumonia can progress quite aggressively and may even spread into the bloodstream if not treated quickly.
  
  
• Viral Pneumonia: This type of pneumonia is triggered by viruses like the flu, COVID-19, or RSV (Respiratory Syncytial Virus). While the virus itself causes inflammation, it often leaves the lungs tired and vulnerable, which is why many people find they develop a bacterial infection right as they think they are getting over a viral one.
  
  
• Aspiration Pneumonia: This is a specific risk for seniors. Over time, the muscles we use for swallowing can weaken (a condition called dysphagia), and our natural "gag reflex" may slow down. This can cause small amounts of food, drink, or even saliva to accidentally slip into the windpipe instead of the stomach. If bacteria from the mouth enter the lungs this way, it can trigger a serious infection.

Why is Pneumonia Particularly Dangerous for Seniors?

While anyone can develop pneumonia, it is significantly more dangerous for older adults for three main reasons:

1. Weakened Immune Systems
   As we age, our "immune memory" and response speed naturally decline, making it harder for the body to fight off infections as quickly as it once could.
   
   
2. Chronic Conditions
   Many seniors manage existing health issues like heart disease, COPD, or diabetes. Pneumonia puts extra stress on the heart and lungs, which can cause these other conditions to flare up.
   
   
3. Atypical Symptoms
   Seniors often don’t show the classic signs of pneumonia. Instead of a high fever, you might experience a lower than normal body temperature or sudden confusion. This can lead to a dangerous delay in seeking care.

Strategies for Prevention

The best way to manage pneumonia is to prevent it from starting. At Flagship Health, we recommend a proactive approach:

• Get Vaccinated: This is your #1 line of defense. Ensure you are up to date on your pneumococcal vaccines, as well as your annual flu and COVID-19 shots.
  
  
• Practice Good Hygiene:Frequent handwashing and using sanitizer help keep viruses and bacteria at bay.
  
  
• Prioritize Oral HealthBacteria in the mouth can migrate to the lungs. Regular brushing and dental checkups can actually lower your pneumonia risk.
  
  
• Manage Chronic Health IssuesKeeping conditions like diabetes or asthma under control helps your immune system stay strong.

The Stages of Pneumonia: Symptoms and Care Strategies for Seniors

In older adults, pneumonia rarely follows a "standard" path. Use the guide below to recognize the subtle shifts in health that require attention.

Stage 1: The Subtle Phase

What to Watch For:Sudden confusion or disorientation. You might feel "foggy," lose your balance, or act unlike yourself. You may also feel unusually tired or lose your appetite.

Care & Action Steps:Don't ignore the "fog." This is often the first sign of infection. Increase fluids (water and warm broth) and rest. Call your doctor to mention these changes.

Stage 2: The Active Phase

What to Watch For:Shortness of breath during simple tasks (like getting dressed). You might have a cough, but you may not have a fever. In fact, your body temperature might be lower than normal.

Care & Action Steps:Contact your primary care team immediately. If the infection is bacterial, you will need antibiotics. Finishing the entire prescription is vital to prevent the infection from returning.

Stage 3: The Emergency Phase

What to Watch For:Chest pain when breathing, a blue-ish tint to the lips or fingernails, or extreme lethargy (difficulty staying awake).

Care & Action Steps:Seek emergency care. This stage indicates your oxygen levels are dangerously low and may require hospital-grade oxygen therapy.

When to Call Your Doctor vs. Go to the Hospital

Make an appointment with your provider if:

• You feel more "foggy," confused, or tired than usual.
• You have a persistent cough or a lingering low-grade fever. 
• You notice a new, slight wheeze when you breathe.

Go to the hospital or call 911 if:

• You are struggling to breathe or have rapid, shallow breathing.
• You experience sharp, stabbing chest pain.
• There is a sudden change in mental status or severe disorientation.

Take Control of Your Respiratory Health

By staying vigilant and prioritizing pneumonia prevention, you are protecting not just your lungs, but your independence and your future.

The most important thing to remember is that you don’t have to wait for a classic symptom like a high fever to take action. If you feel a sudden shift in your energy, a bit more foggy than usual, or a slight catch in your breath, trust your intuition. Catching pneumonia in its earliest stages is the best way to avoid the hospital and get back to the activities you love.

At Flagship Health, we work with seniors to create a personalized pneumonia prevention plan, manage vaccinations, and provide quick, expert care at the first sign of symptoms.

Request an appointment at either of our San Antonio clinics.