Respiratory Disease

There are two major classes of respiratory disease that affect older adults, asthma and Chronic Obstructive Pulmonary Disease (COPD).

According to the American Lung Association (ALA), “the average adult takes 15 to 20 breaths a minute — over 20,000 breaths a day. To breathe, the respiratory system brings air into the body through the nose, throat, windpipe (trachea) and lungs. In the lungs, the oxygen from each breath is transferred to the bloodstream and sent to all the body’s cells as life-sustaining fuel.” Keeping lungs healthy involves breathing in less smoke, germs and harmful chemicals.

Asthma is a chronic lung disease that causes periods of wheezing, chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning. The airways are tubes that carry air into and out of the lungs; people who have asthma have inflamed airways. This makes the airways swollen and very sensitive. They tend to react strongly to certain substances when breathed in, causing the muscles around them to tighten. This causes the airways to narrow, and less air flows to the lungs.

Asthma affects people of all ages, but it most often starts in childhood. In the United States, more than 22 million people are known to have asthma. Some contributors, besides smoking and being overweight, include family tendency, low birth weight, and exposure to exhaust fumes or other forms of pollution as well as chemicals used in certain occupations such as hair dressing or farming.

A strong partnership with a doctor helps to achieve successful, comprehensive, and ongoing treatment. The doctor can determine if certain medications can be used for long-term control as well as for quick relief in the case of an asthma attack. Sometimes allergy shots or medications are useful in controlling asthma.

Risk Factors

  • Genetics
  • Allergies, especially if family members have a predisposition to them
  • Environment including contact with allergens, pollutants, and other irritants that may affect the immune system
  • Respiratory infections, especially damage to the lungs in childhood


  • Stop smoking cigarettes, because when the air passages are narrowed, breathing is more difficult. Cigarette smoke causes chronic inflammation and swelling in the lungs, which leads to chronic bronchitis. The destruction of lung tissue may lead to cancer. Medicare will pay for counseling to prevent tobacco use and smoking, as well as, tobacco-use cessation counseling.
  • Avoid environmental pollutants such as secondhand smoke, outdoor air pollution, chemicals in the home and workplace and radon. Make the home and car smoke-free.
  • Do not exercise outside on high pollution days. According to the Environmental Protection Agency (EPA), which has developed a color-coded system, when the air quality index is orange or is more than 101 parts, certain groups may experience sensitivity to air pollution. You can check today’s air condition online.
  • Avoid infections by washing hands often with soap and water (use alcohol based cleaners if you cannot wash). According to the Centers for Disease Control and Prevention “wash hands before preparing food and after handling uncooked meat and poultry; before eating; after changing diapers; after coughing, sneezing, or blowing one’s nose into a tissue; after using the bathroom; and after touching animals or anything in the animal’s environment.”
  • Practice good oral hygiene to prevent plaque, a sticky substance that collects around and between teeth, by brushing your teeth at least twice a day and seeing a dentist every six months.
  • Get a flu shot annually and pneumococcal shot per your health care providers’ advice. Both of these immunizations are covered by Medicare (if you are a member of a Medicare Advantage Health Plan, you will need to use their providers to avoid a co-payment)
  • Avoid crowds during cold and flu season. If you get sick, stay home.

A spirometry test measures the amount and speed of air you blow out and can be used to diagnose respiratory problems like asthma. You can also take the Asthma Life Quality Test developed by American College of Asthma, Allergy and Immunology. This is a 20-point questionnaire designed to determine if you should be screened further for asthma and allergies.

Treatment & Management

  • Participate in the Breathe Well, Live Well self-management ten-step program sponsored by the American Lung Association to control asthma. Programs may be available in local areas to help manage your asthma.
  • Use your air conditioner. Clean or change filters and air ducts frequently.
  • Minimize dust mites by using dust proof covers for mattresses and pillows by washing monthly.
  • If you use a humidifier, change the water daily. Change the filter quarterly or wash frequently if it is the type that is able to be cleaned.
  • Change filters in the furnace and air conditioner as recommended by the manufacturer.
  • Reduce pet dander If at all possible use a HEPA filter vacuum.
  • Clean the house regularly. Use a mask if dust is kicked up in the process.
  • If it’s cold outside, cover your face.
  • During each season, some environmental changes may trigger an asthma attack. Prepare for the ones that cause you discomfort, develop an action plan, and consult with your health care provider.

Questions For Your Doctor

  • Are there lifestyle habits I can change to get some asthma relief and reduce my risk of an asthma attack? What are my triggers?
  • What kinds of asthma tests will I need?
  • Are there some natural therapies I can use along with my asthma medications?
  • Is it safe to exercise with asthma?


  • Work with your health care provider to determine what triggers an asthma attack.
  • If you are using a rescue inhaler more than twice a, and then make an week, it is time to revisit your action plan with your action plan to avoid the triggers medical team.

Helpful Resources
American College of Allergy, Asthma & Immunology or call 847-427-1200
American Lung Association or call Lung Helpline at 1-800-548-8252
National Jewish Hospital or call 1-877-225-5654
Environmental Protection Agency

COPD: Chronic Obstructive Pulmonary Disease
COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. In the United States, the term “COPD” includes two main conditions—emphysema and chronic bronchitis. In emphysema, the walls between many of the air sacs are damaged, causing them to lose their shape and become floppy. In chronic bronchitis, the lining of
the airways is constantly irritated and inflamed. This causes the lining to thicken Lots of thick mucus forms in the airways, making it hard to breathe.

COPD is a major cause of disability, and it’s the fourth leading cause of death in the United States. More than 12 million people are currently diagnosed with COPD. Many more people have the disease and do not know it. COPD develops slowly. Symptoms often worsen over time and can limit the ability to do routine activities. Severe COPD may prevent patients from doing even basic activities like walking, cooking, or taking care of themselves. The lag time between when a person began to smoke and the development of COPD is 10 or more years.

Most of the time, COPD is diagnosed in middle-aged or older people. The disease isn’t passed from person to person—you can’t catch it from someone else.

Cigarette smoking is the leading cause of COPD. Most people who have COPD smoke or used to smoke. Long-term exposure to other lung irritants, such as air pollution, chemical fumes, or dust may also contribute to COPD.

Symptoms of COPD include an ongoing cough or cough that produces large amounts of mucus (sometimes called a ‘smoker’s cough’), shortness of breath (especially with physical activity) and wheezing and chest tightness.


  • Stop smoking
  • Avoid lung irritants
  • Avoid perfume and use unscented products such as soap and lotion
  • Exercise as much as you can
  • Talk with your doctor about ways to maintain a normal lifestyle

Screening & Diagnosis
A spirometry test measures the amount and speed of air you blow out and can be used to diagnose respiratory problems like COPD. An official diagnosis will include a physical exam (with health history), a spirometry test and chest x-rays.

Treatment & Management

  • Use the American Lung Associations’s COPD Management Tool to help you talk with your doctor to make a personal action plan. With an action plan, you will know how and when to take your medicines, when to call your healthcare provider and when to get emergency care. A management plan also helps you track how you are doing, any concerns you may have and any changes in your health that are important to discuss with your doctor.
  • Using medications including an inhaler may be effective. Advanced cases may need a nebulizer.
  • Use oxygen either on a 24-hour basis or only at night.
  • Participate in a pulmonary rehabilitation program which includes medical management, exercise, education, emotional support, and nutrition counseling.
  • Avoid infections.

Questions For Your Doctor

  • Will there be a time when I can’t take care of myself and need to be in a nursing home?
  • How long do I have to live?
  • What is it like to die of COPD? Will it hurt? Will it feel like I’m drowning?

Smoking is a habit of association. You never crave a cigarette in the shower, but perhaps always when you drink coffee. Try to disassociate one or two things each week.

Helpful Resources
American Lung Association or call Lung Helpline at 1-800-548-8252
National Jewish Hospital or call 1-877-225-5654

Download This Respiratory Disease Monogram