Reasons For Chronic Cough in Older Adults

Reasons For Chronic Cough in Older Adults

Chronic cough is among the most common and irritating symptoms in the elderly, making it imperative to understand the reasons for its occurrence for effective management and therapy. In Singapore, as in many parts of the world, this condition badly affects a large proportion of the elderly population. Chronic cough is normally considered to be a cough that lasts longer than eight weeks, and it can be caused by many different underlying health problems. This article shall discuss some of the most common causes for chronic cough in elderly patients and also address some of the contributing factors.

Chronic Cough Older Adults

1. Chronic Obstructive Pulmonary Disease (COPD)

Chronic obstructive pulmonary disease is one of the more common causes of chronic cough in elderly patients. COPD is a group of advanced lung diseases characterised by progressive airflow limitation, which is usually caused by emphysema and chronic bronchitis. When the airways are inflamed and damaged, chronic coughing is quite common in patients. COPD is therefore characterised by excess production of mucus and airway obstruction in older adults, causing a constant cough. COPD is often associated with a history of smoking; however, non-smokers also have the potential to develop the condition through long-term exposure to other irritants.

  • Persistent Cough: Often accompanied by mucus production.
  • Breathlessness: Difficulty in breathing, particularly with physical activity.
  • Wheezing: A whistling sound when breathing.

2. Gastroesophageal Reflux Disease (GERD)

The other cause for chronic coughing in an elderly individual is gastroesophageal reflux disease. Gastroesophageal reflux happens when there is frequent leakage of stomach acid into oesophagus organs, hence irritating them and resulting in inflammation. This acid reflux could be the stimulus for producing constant cough by irritating the throat and airways. Older individuals are more prone to GERD due to the age-related changes in their digestive system, which result in weakened lower esophageal sphincter and delayed gastric emptying. The treatment of reflux usually includes lifestyle modifications, medications, and dietary alterations that will aid in the reduction of acid production and reflux.

  • Acidic Taste: A sour taste in the mouth from stomach acid.
  • Heartburn: Burning sensation in the chest.
  • Regurgitation: The sensation of acid backing up into the throat.

3. Post-Nasal Drip

Post-nasal drip is a syndrome where excess mucus from the nasal passages drips down into the trachea at the back of the throat. This can irritate and provoke coughing. In the elderly population, post-nasal drip can result from chronic sinusitis, allergies, or nasal polyps. Dripping from the nose down into the throat may irritate it and provoke this disease. Chronic cough treatment typically focuses on addressing the underlying cause of post-nasal drip through nasal sprays, antihistamines, or decongestants.

  • Chronic Sinusitis: Persistent inflammation of the sinuses.
  • Allergies: Reaction to allergens causing mucus production.
  • Nasal Polyps: Growths in the nasal passages causing mucus accumulation.-

4. Asthma

Although asthma is usually diagnosed in younger patients, the very same thing can first happen, or at least be newly diagnosed, in older adults. Asthma consists of inflammation and narrowing of the airways, leading to symptoms such as wheezing, shortness of breath, and chronic coughing. Asthma can often be overlooked and misdiagnosed in the elderly for other respiratory diseases, consequently delaying proper treatment. Asthma must be considered in the differential diagnosis of chronic cough among the elderly, particularly when all other etiologies have been excluded.

  • Wheezing: A high-pitched whistling sound when exhaling.
  • Shortness of Breath: Difficulty breathing, especially during physical activity.
  • Chest Tightness: A feeling of pressure or tightness in the chest.

5. Medication Side Effects Leads To Constant Cough

A chronic cough is a side effect of some medications, especially ACE inhibitors used to treat hypertension. ACE inhibitors act by inhibiting an enzyme that participates in blood pressure regulation, but it also increases the levels of bradykinin, which is a substance that causes irritation to the airways, resulting in coughing. If cough is chronic, mainly in older patients, and the patient is on ACE inhibitors, a different medication should be prescribed while being monitored by the doctor.

  • Dry, Persistent Cough: Often without other respiratory symptoms.
  • Persistent Coughing: Continuing despite the absence of other symptoms.

6. Smoking and Environmental Exposures

Causes of Chronic Cough

Smoking is a major risk factor for chronic cough even in older persons. Chronic bronchitis and other conditions that cause chronic coughing can be related to long-term smoking. Other respiratory diseases can also be caused or aggravated by exposure to environmental pollutants like secondhand smoke or air pollution, thus giving rise to a persistent cough with phlegm. Reduction or avoidance of contact with these irritants is an essential aspect of the management of cough in elderly patients.

7. Obstructive Sleep Apnea (OSA)

Obstructive sleep apnoea (OSA) is a sleep disorder in which an individual’s airway is partially closed during sleep and breathing is frequently disturbed, resulting in frequent waking. Due to irritation of the air passage from recurrent obstruction and snoring, this may cause chronic coughing. The general disturbances in breathing at night are very common among the elderly population and are prevalent in subjects with underlying disorders like obesity or cardiovascular disease. Treatment often includes lifestyle modifications, CPAP therapy, and management of contributing factors.

  • Snoring: Loud and frequent snoring.
  • Daytime Sleepiness: Excessive tiredness during the day.
  • Morning Headaches: Headaches upon waking.

8. Heart Failure

Chronic Cough Treatment

Heart failure in older adults can lead to pulmonary congestion, a condition whereby fluid seeps into the lungs from the bloodstream since the heart is too weak to effectively pump out the blood. The fluid can seep into the airways and cause a nagging cough. Other possible symptoms of heart failure are shortness of breath, swelling of the legs, and fatigue. Treatment of heart failure is usually focused on treating the underlying heart disease and may be managed with medications, lifestyle modifications, and other therapeutic measures.

Conclusion

Older adult chronic cough can result from a lot of etiologies, which require various modes of management. The establishment of these causes is quite important in effectively providing treatment and enhancing the quality of life in these patients. For older adults with chronic cough treatment, the need to consult a doctor is necessary to establish the cause of this disorder and come up with a proper treatment plan. Addressing the underlying causes with chronic cough treatment can drastically improve symptoms and overall health.