Understanding Chronic Coughing Issues in Older Adults

Understanding Chronic Coughing in the Elderly

Coughing is the body's natural reflex to clear the airways. However, chronic excessive coughing can significantly impact quality of life in the elderly. As people age, the immune system weakens and the body becomes more vulnerable to conditions that produce stubborn coughs. Learning about the potential causes, treatments, and when to seek medical care can help older adults and caregivers manage troublesome coughing.

Common Causes of Chronic Coughs in the Elderly

Some of the most frequent reasons elderly people deal with chronic cough include:

• Post-viral cough: Lingering cough after a respiratory infection like a cold or flu.
• COPD: Chronic obstructive pulmonary disease causes coughing due to lung damage.
• Pneumonia: Lung inflammation from pneumonia bacteria or viruses provokes cough.
• Asthma: The airway restriction of asthma leads to coughing episodes.
• Interstitial lung disease: Scarring and inflammation in lung tissues induces cough.
• Congestive heart failure: Fluid buildup in the lungs from heart failure results in cough.
• Gastroesophageal reflux disease (GERD): Acid reflux aggravates cough by irritating the throat.
• Medications: Coughing is a side effect of many common medications.

Characteristics of Chronic Coughs in the Elderly

Some signs that suggest an elderly person’s chronic cough may warrant medical attention include:

• Lasting longer than 8 weeks
• Worsens at night
• Produces yellow, green, or bloody mucus
• Occurs after eating or drinking
• Leads to vomiting or lightheadedness
• Associated shortness of breath or wheezing
• Disrupts sleep

Keeping a log noting when coughing occurs, triggers, and characteristics can help identify patterns for discussion with a doctor.

Risks of Chronic Coughing in the Elderly

While coughing is normally a protective reflex, uncontrolled chronic coughing has potential complications for the elderly, including:

• Fatigue: The energy expenditure and sleep disruption of frequent coughing leads to exhaustion.
• Muscle strains: The strong contractions during coughing spells can cause injuries and soreness.
• Vomiting: Severe coughing fits can trigger gagging and vomiting.
• Lightheadedness: Vigorous coughs reduce blood flow to the brain, resulting in dizziness or fainting.
• Incontinence: Intense coughing pressure can cause bladder leakage.
• Rib fractures: Frequent heavy coughs can weaken bones made fragile by osteoporosis.
• Hernias: Increased abdominal pressure from coughing can lead to abdominal organ protrusions.
• Cardiac issues: Strenuous coughing can strain the heart and alter heart rhythms.

Treatment Options for Chronic Cough in the Elderly

Treatment strategies focus on both soothing the cough itself and addressing any underlying lung conditions contributing to coughing. Options include:

• Cough suppressants: Over-the-counter cough medicines with dextromethorphan or codeine derivatives provide short-term relief.
• Cough expectorants: Guaifenesin thins mucus secretions to improve productive coughs.
• Antihistamines: Reducing postnasal drip with antihistamines can lessen associated coughing.
• Albuterol inhalers: Inhaled bronchodilators like albuterol open restricted airways to minimize asthma-related coughs.
• Antibiotics: Bacterial respiratory infections causing cough are treated with appropriate antibiotic regimens.
• Inhaled steroids: Drugs like fluticasone help control inflammatory lung conditions prompting cough.
• GERD medications: Reducing reflux with proton-pump inhibitors like omeprazole alleviates related coughing.

Lifestyle adjustments like smoking cessation, dietary changes, oxygen therapy, and pulmonary rehabilitation exercises also aid chronic cough management.

When to See a Doctor About an Elderly Cough

It is important older adults consult a physician if they experience:

• A cough persisting over 8 weeks
• Cough produces blood-tinged mucus
• Difficulty breathing or wheezing with cough
• Unexplained weight loss
• Fever over 100.4°F
• Night sweats along with cough
• Chest pain when coughing
• Dizziness, fainting, or confusion

A doctor can perform exams and tests to diagnose the underlying cause, check for complications, and prescribe appropriate treatments.

Common Causes of Chronic Coughs in the Elderly

Here is more in-depth information on some of the most frequent medical conditions producing chronic coughs in seniors:

Post-Viral Cough

Colds, influenza, respiratory syncytial virus, and other viral illnesses often leave seniors with lingering coughs. Inflammation from the infection sensitizes airway nerves, leading to easy triggering of cough reflexes. Post-viral coughs tend to fade over time. Soothing approaches include cough medicine, throat lozenges, humidifiers, and hydration.

COPD

Chronic obstructive pulmonary disease (COPD) encompasses emphysema and chronic bronchitis. Cigarette smoking is the top cause of COPD. The chronic lung inflammation causes narrowing of air passages, making breathing difficult and inducing coughing fits. Medications like bronchodilators and steroids help open airways and reduce COPD-related coughs.

Pneumonia

Bacterial or viral lung infections cause the air sacs in the lungs to fill with fluid during pneumonia. This triggers cough as the body tries to expel the fluid obstructing airflow. Pneumonia is especially common in the elderly. Antibiotics treat underlying bacteria while rest, fluids, and cough medicine provide comfort until pneumonia resolves.

Asthma

Asthma causes swelling and spasms of the bronchial tubes. Irritants like allergens, smoke, and respiratory infections can trigger asthma flares featuring coughing, wheezing, tightness in the chest, and shortness of breath. Inhalers delivering bronchodilators and steroids prevent and relieve asthma cough episodes.

Interstitial Lung Disease

Interstitial lung diseases like pulmonary fibrosis involve scarring and inflammation of lung tissues. The damage stiffens lungs and lowers oxygen levels, resulting in chronic dry cough. Cough from these progressive diseases can be difficult to manage, but some find relief using codeine or morphine-based cough medicines.

Treating Bothersome Coughs in the Elderly

While most chronic coughs require diagnosis and prescription treatments, some at-home remedies may supplement medical therapies and provide additional relief for the elderly, including:

Humidifier

Using humidifiers adds needed moisture to the air, which can soothe dry airway passages irritated by coughs. This is especially helpful during cold, dry months when coughs tend to worsen from dry air. Clean humidifiers often to avoid spreading mold and bacteria.

Honey

Honey coats and soothes the throat while providing some antibacterial benefits. Drinking warm tea mixed with honey or taking a teaspoon of honey straight several times per day may reduce coughing fits. Elderly people should avoid raw honey due to infection risks.

Salt Water Gargling

Gargling with warm salty water can remove mucus and irritants from the throat, promoting healing. Dissolve 1⁄4 to 1⁄2 teaspoon of salt in a glass of warm water and gargle a few times a day to cleanse the throat and wash away cough triggers.

Vapor Rubs

Mentholated vapor rubs like Vicks VapoRub provide topical analgesic and cooling relief when applied to the chest and throat area. The menthol temporarily desensitizes cough receptors. Take care to avoid contact with eyes and mucous membranes.

Cough Drops

Throat lozenges deliver soothing ingredients along with mild pain relief directly to irritated throat tissues. Breathing the vapors released can further suppress cough reflexes. Ricola and other brands make sugar-free versions safe for diabetics.

When to Seek Emergency Care for Coughing

While chronic coughs are typically not serious, emergency care is warranted if the elderly experience:

• Coughing up copious amounts of blood
• Sudden worsening of cough with chest pain and trouble breathing
• Lips or fingers turning blue or gray during coughing fits
• Confusion, dizziness, or fainting accompanying cough spells
• New fever over 102°F with productive cough
• Struggling for breath or unable to stop coughing

These signs can indicate potentially life-threatening conditions like pneumonia, pulmonary embolism, respiratory failure, or heart attack. Prompt medical treatment is vital in these cases. Call 911 or seek emergency care for any cough symptoms causing sudden distress or impairment.

When to Talk to a Doctor About Chronic Coughs

While most coughs run their course, it is important seniors experiencing chronic coughing contact their doctor if they have:

• Cough lasting over 8 weeks
• Frequent cough that disrupts sleep
• Cough worsens when lying down
• Onset of cough with no apparent cold or flu
• New cough along with chest tightness or wheezing
• Weight loss or fatigue associated with cough

A physician can evaluate the cough and screen for any serious underlying disorders. Early treatment improves outcomes with chronic lung diseases and cancers that cause coughing.

The Bottom Line

Coughing is very prevalent in the elderly due to age-related vulnerability to lung conditions. While usually harmless, chronic coughs can impair daily life. Paying attention to any worrisome characteristics and consulting a doctor for coughs lasting over 2 months can improve seniors' well-being and prevent complications. Implementing both medical therapies and home remedies allows for the most effective cough management.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.