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Curb the Colds

By: Marc Evans Abat, MD, FPCP, FPCGMCurb the Colds

Colds in adults are really “common.”  In fact, a healthy adult can expect to have colds possibly up to three times a year.  Most people would just shrug it off only because they are still able to go to work and perform many activities despite feeling a bit crummy for the next several days.  It usually does not cause any significant or serious problem for many.

Older persons are, of course, different.  Colds may still be a relatively benign, self-limiting problem for most seniors.  But in a significant proportion, it can be a prelude to more sinister things to come.

The older person's immune system undergoes some senescent changes that can make them more vulnerable to infections.  Structural changes in the upper airways from exposure to noxious gases like cigarette smoke and pollution also predispose to easier penetration of infectious agents.  Nutritional problems contribute to lower immunity.  A reduced physiologic reserve or frailty, other existing medical conditions, and medication intake may lead to more pronounced symptoms from colds.  Seniors may feel much worse with the colds and need more days to recover.  More importantly, colds may facilitate superinfection with other microorganisms, leading to more serious conditions like pneumonia.

So, how do you prevent your seniors from getting a cold?  Physical interventions are important to prevent transmission and acquiring the viruses.  These include frequent handwashing or use of hand disinfectants (including alcohol-based), face masks (even just regular surgical face masks), gloves, or other physical barriers.  Frequent disinfection of possibly infected items and surroundings can help prevent infections. 

It is also very important for seniors to avoid exposure to other persons with colds.  So if your grandkids have colds, it’s better to temporarily keep yourself at a distance for a few days.  Supplements like zinc may work for older adults, although the evidence is mainly for children.  Probiotic supplements have inconsistent effects but may be helpful.  Both seem to work by helping boost the immune system. 

Those with questionable benefits for preventing colds include saltwater gargling, taking ginseng, vitamin C, and garlic as well as engaging in exercise and homeopathy. They may be of some benefit for those who are physically-stressed but the overall benefit is not clear.

But what if an older person inevitably catches the colds?  What can he take to relieve his symptoms?  Decongestants help relieve the stuffiness and reduce nasal secretions.  Taking antihistamine together with the decongestant may help if an allergic component is also suspected.  Make sure to monitor the older person's blood pressure, especially if decongestants are taken.  These may also cause some degree of drowsiness.  Using camphor and menthol vapor rubs may help with some of the symptoms but the usual adverse reaction includes burning sensation in areas where it is applied.  Saline nasal drops may also help with the nasal stuffiness.  Saltwater gargles relieve some of the throat irritation. One can also take paracetamol tablets as needed for the pain associated with the nasal congestion.  It is also important to drink lots of water to keep yourself hydrated and continue with a balanced diet.  Vitamin C and echinacea have unclear benefits.  The latter may be used to shorten the duration of the colds, but it may interact with medications taken by older persons.

It is very important to see your doctor if the symptoms persist or worsen, especially if one develops a cough, difficulty in breathing, high fever or worsening weakness.  This may indicate the development of more severe diseases.

I hope this helps shoo away the achoo!

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