Billy Graham improving; pneumonia a particular threat for the elderly

Evangelist Billy Graham, who is 93 years old, was hospitalized Wednesday in Asheville, N.C., and subsequently diagnosed with pneumonia. It was the second time in about six months that Graham has been treated for the condition.

As of Thursday afternoon, the Billy Graham Evangelistic Assn. Website reported that the reverend ate sitting in a chair in his hospital room, and that he was walking and chatting with hospital staff. Graham’s pulmonologist said that he “looks better.” There was still no date planned for his release.

Pneumonia, an infection of the lung that can be caused by bacteria or viruses, can strike anyone -- but it poses particular risk for older people. A 2008 review published in the Southern Medical Journal by Australian researchers Dr. Carol Chong and Dr. Philip Street explains some of the reasons why.

They reported some stark statistics: The annual rate of pneumonia in people 65 or older is 25 to 44 per 1,000 people, and for those in residential care facilities the rate shoots up to as many as 114 per 1,000 -- with a mortality rate reported to be as high as 44% to 57%. Older people are hospitalized for pneumonia more than four times more often than younger people.

The reason for older people’s higher risk? Other diseases and conditions associated with aging. For instance, the coauthors wrote, aging-related declines in lung performance play a role, as well as a weakening cough reflex, malnutrition and poor oral hygiene. Advanced age can make it more likely that a person will inhale bits of their food, which can cause the disease too. And unlike younger people who are likely to have a strong immune response to the infection -- and therefore, severe symptoms -- older folks sometimes don’t develop fever and therefore only realize they’ve developed pneumonia relatively late.

According to news reports, Graham had a cough, congestion and a slight fever when doctors at the North Carolina hospital decided to keep him overnight for observation.

An article on pneumonia in the elderly in Slate magazine also noted that elderly people may be less able to tolerate the antibiotics used to treat the illness than younger people are.

Click here for PubMed’s page on pneumonia.

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