6 July 21 SM 01

Why Respiratory Diseases Can Be More Serious In Elderly?

Respiratory disease means any of the diseases and disorders of the airways and the lung that affect human respiration. It can range from mild and self-limiting such as influenza, common cold, cough, sore throat and runny nose to life-threatening diseases like tuberculosis, pneumonia, asthma, lung cancer and severe acute respiratory syndromes such as Covid-19.

Respiratory infections are a leading cause of morbidity and mortality in the elderly. It can be due to viruses, bacteria or fungi. Symptoms are usually a combination of lung-related symptoms such as difficulty breathing, chest discomfort and coughing (with or without phlegm), alongside more general symptoms like lethargy, fever and weight loss.


In Malaysia, a local study has indicated that those above the age of 65 infected with influenza-like illnesses are at a 10% greater risk of mortality. (1)


Unfortunately, many people still do not realize how vital respiratory health is when it comes to aging well. In fact, keeping your respiratory system healthy can improve your quality of life and help you live longer.


Aging is associated with multiple structural changes in the respiratory system, resulting in increased susceptibility to disease processes. As we age, factors such as impaired immunity and malnutrition tend to increase the risk of respiratory infection.


Immune System in Elderly

Immune function naturally decreases with age, which makes seniors more susceptible to respiratory illnesses. As we grow older, our immune system does not work as well and becomes slow to respond. Therefore, older adults have a far higher risk of contracting infections and severe complications than younger people.


The Elderly are more likely to get sick.  As people age, not only do they have fewer immune cells but the ones they have do not communicate well with each other. It means the immune cells take longer to react to harmful bacterial. As a result, elderly individuals do not respond to the immune challenges as robustly as the young and they also tend to recover from infections and illnesses more slowly.


Apart from that, the immune system of the elderly will be even weaker when an older adult is also living with a chronic condition such as diabetes, high blood pressure, heart disease and cancer. People with underlying chronic conditions are often in active inflammatory states, which may compromise the efficacy of their immune systems.

Ways to Improve Immunity and Respiratory Health

Ø Eat well-balanced meals

A healthy diet is essential to a strong immune system. Older adults sometimes have issues with immunity because of a lack of sufficient nutrition. Difficulty chewing, swallowing or poor dental health can contribute to malnutrition. Not getting enough essential vitamins and minerals can make the immune system work harder.

  • A well-balanced diet includes a variety of fruits, vegetables, whole grains, a variety of protein foods, fat-free/low-fat dairy and healthy fats.
  • Use more healthy cooking methods such as steaming, boiling, poaching, stewing, baking or stir-frying.
  • For the easy chewing purposes, try to chop vegetables into smaller sizes, cook meat until soft, blend the soup into pureed or soak wholegrain bread into milk.
  • Try to include some key immune-boosting supplementation if the elderly is really unable to get it through diets such as Protein, Vitamin C, Vitamin D and Zinc.


Ø Exercise and stay active

Exercise is one of the most important ways to keep the respiratory system healthy. Regular exercise can help the immune system function at optimal levels to fight off viruses and infection, increases blood circulation and also make the muscles, heart and lungs stronger. Current research stated that physical exercise is seen as the main ally for health promotion, preventing and protecting the elderly from several diseases infections. (2)


Aim for at least 30 minutes of physical activity a day. Brisk walking, tai chi, yoga, deep breathing exercise and cycling are just some of the many ways older adults can get sufficient exercise. It is important to encourage your aging loved ones to find enjoyable activities that match their fitness level.


Ø Spend time outdoors

Vitamin D, known as the “Sunshine Vitamin “, helps to strengthen the immune system. Spending additional time outdoors allows the body to naturally convert vitamin D from sun exposure and improve overall immunity. Research suggested that Vitamin D has a potential role in the prevention of respiratory tract infections by increasing immunity. (3)   


By spending just 15 minutes outside in the sunshine each day, will help their body receive the dose of Vitamin D. Gardening is one of the most popular outdoor activities for elderly. Remember to head outside when the sun is not too strong to avoid a sunburn.


Ø Stay hydrated

Dehydration is a very common problem in the elderly and often leads to many health issues. Dehydration can cause mucus to thicken and get sticky, which slows down the overall respiratory and make the elderly more susceptible to illness and other respiratory problems. A study suggested that dehydration resulted in immunosuppression, including decreased neutrophil (an important type of tissue-healing and infection-fighting white blood cell) function. (4)


Adequate hydration is a key immune booster for the elderly. Water helps their body absorb nutrients and minerals, and flush body waste.  Drinking at least eight glasses of fluid a day can help them avoid dehydration. Some tips to help your aging loved one stay hydrated:

  • Drink a glass of water before and after every meal and in-between snacks.
  • Try Keeping a water bottle/cup near their favorite seat for sipping throughout the day.
  • Try to offer some smoothies, milkshakes or soup.
  • Try adding some fruits like berries, lemons, limes, cucumbers and mint to water for flavor.


Ø Get plenty of sleep

Insufficient sleep not only reduces the effectiveness of the immune system to respond to infection and inflammation, but it also linked to many chronic diseases such as diabetes, heart disease, obesity and depression. As we age, we often experience changes in our sleeping patterns, such as becoming sleepy earlier, waking up earlier, experiencing less deep sleep or even having insomnia. A study showed that short sleep duration (5 hours or less) and sleep disturbances (insomnia) increased susceptibility to upper respiratory tract infection. (5)


For the elderly, try to aim for at least seven to eight hours of sleep each night on a regular schedule. Some ways to improve the quality of sleep among the elderly include:

  • Keep a consistent bedtime routine.
  • Limit daytime naps to no more than 45 minutes.
  • Do some gentle stretches to relieve built-up tension before bedtime.
  • Making the bedroom a comfortable sleep environment.


In a nutshell, the immune system becomes less effective in the elderly compared to younger people. The changes in immune function may contribute to the greater susceptibility of older people to some infections and may lead to more serious disease complications. Thus, it is important to take steps to strengthen the immune system in the elderly to reduce the risk of any respiratory diseases.



  1. Pui Li Wong et al. The effects of age on clinical characteristics, hospitalization and mortality of patients with influenza-related illness at a tertiary care centre in Malaysia. Influenza Other Respir Viruses. 2020 May;14(3):286-293.
  1. Fabiana et al. Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period. Front Psychol. 2020; 11: 593903
  1. Jaykaran charan et al. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012 Oct-Dec; 3(4): 300–303.
  1. Takeharu Chishakiet al. Effects of dehydration on immune functions. Luminescence. Mar-Apr 2013;28(2):114-20.
  1. Aric A Pratheret al. Association of Insufficient Sleep With Respiratory Infection Among Adults in the United States. JAMA Intern Med. 2016 Jun 1;176(6):850-2.

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One thought on “Why Respiratory Diseases Can Be More Serious In Elderly?

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