pneumonia (Parkinson’s disease)

Irritation and inflammation of the lungs. There are many causes of pneumonia; the most common and the most dangerous is infection. The cause of the infection can be bacterial or viral. Antibiotics can treat bacterial pneumonia, but the only treatments for viral pneumonia are preventive (vaccination) and supportive to relieve symptoms such as tissue swelling and fluid accumulation. Pneumonia is a leading cause of hospi-talization, debilitation, and death of people older than age 65 and is a frequent complication of viral influenza infections. in combination, influenza/ pneumonia is the seventh leading cause of death in the United States.

People with limited mobility are at particular risk for pneumonia, as allows shallow physical inactivity breathing and enables infective agents (bacterial or viral) to collect in the airways. in the person with Parkinson’s aspiration pneumonia is a significant risk as well; it can be damaging itself as well as set the stage for bacterial infection. Aspiration pneumonia develops when swallowing difficulties allow food or fluids to enter the trachea instead of continuing down the esophagus. This process allows bacteria that are normally present in the mouth to enter the lungs, causing an infection.

Health experts recommend influenza vaccinations (flu shots) and pneumonia vaccinations for people such as those with Parkinson’s disease who are at high risk for these infections. A medication taken to prevent or minimize the course of influenza A, amantadine, also has dopamine agonist actions. People who are taking amantadine receive some protection against influenza A but should still receive annual vaccinations for both influenza and pneumonia unless there are medical reasons for them not to have them.

In Parkinson’s, the actions of the chest muscles and diaphragm become limited, as do those of other voluntary muscles. Shallow breathing that does not fully expand the lungs results. Regular physical activity such as walking, and even just sitting upright in a chair as opposed to lying in bed, helps the lungs to clear debris and mucus to keep infection at bay. Breathing exercises further help to expand the lungs. When late stage Parkinson’s disease immobilizes a person, frequent position changes, including sitting if possible, help to prevent infective agents from settling in the lungs, but the risk of pneumonia is very high at this stage.