For most people, the flu is a mild yet unpleasant illness. Fever, chills, congestion, sore throat, muscle aches and fatigue generally leave people feeling lousy for a few days. Most people who catch the flu do not need medical care and fully recover in less than two weeks. However, seniors and individuals with compromised health face very different risks.

The flu can cause serious complications like pneumonia and bronchitis that may necessitate hospitalization. In some cases, these complications can cause death. In fact, adults older than age 65 account for 90 percent of flu-related deaths and 60 percent of flu-related hospitalizations according to the Centers for Disease Control and Prevention (CDC).

“Elderly people who have chronic health conditions are particularly at risk for several reasons,” explains Tom Skinner, senior public affairs officer for the CDC. “First, the immune system weakens with age, leaving older adults more vulnerable to disease. Secondly, chronic health conditions can exacerbate the flu, making it worse, which leads to serious complications.” Likewise, the flu can make chronic health problems worse.


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Medical Conditions That Increase the Risk of Flu-Related Complications

The CDC specifies the following chronic conditions as factors that heighten a senior’s risk of developing flu-related complications, such as pneumonia, sinus infections and ear infections.

  • Diabetes: People with diabetes (type 1 or type 2) are at high risk of developing complications of influenza. Contracting an illness like the flu can affect blood sugar levels and cause dangerous spikes and/or drops. Diabetics typically have weaker immune systems, which means that even minor infections can become life-threatening very quickly.
  • Asthma, chronic lung disease and COPD: People with chronic respiratory conditions are more susceptible to flu complications due to their already compromised lung function. Any respiratory infection, including the flu, can cause inflammation and airway narrowing, making it difficult to breathe and get adequate oxygen. This inflammation can lead to an increase in asthma attacks and COPD exacerbations. In fact, adults with asthma are more likely to develop pneumonia after contracting the flu than those without.
  • Heart disease: While heart conditions don’t necessarily increase a senior’s risk of contracting the flu, they certainly increase the risk of complications. Individuals with heart disease, congenital heart defects, congestive heart failure, coronary artery disease and a history of stroke who contract the flu have an elevated risk of heart attack and stroke, which can be deadly.
  • Kidney disorders: Chronic kidney disease can weaken the body’s ability to fight off infections like the flu. Consequently, the flu can exacerbate symptoms of kidney disease and damage these vital organs. Individuals who have received a kidney transplant and contract the flu could even end up rejecting the new kidney.
  • Liver disorders: Just like in individuals with limited renal function, the flu can exacerbate liver disease. Flu can also cause the body to reject a transplanted liver. Unfortunately, the medications that individuals with liver and kidney disease can take to help treat the flu virus are limited because many of them are metabolized by these organs. If the kidney and liver are already compromised, then taking certain medications can cause additional harm.
  • Neurological conditions: Health problems like epilepsy, Parkinson’s disease, history of stroke and Huntington’s disease can weaken the body’s ability to fight off the flu.
  • Cancer and HIV: Any disease or treatment plan that causes a weakened immune system, such as HIV and chemotherapy for cancer treatment, can increase a person’s likelihood of contracting the flu and developing related complications.

Signs of Serious Flu Complications

Summon emergency medical care right away if you notice any of the following symptoms in an elder with the flu:

  • Difficulty breathing or chest pain
  • Purple or blue discoloration of the lips
  • Vomiting and inability to keep liquids down
  • Signs of dehydration, such as feeling dizzy when standing and inability to urinate
  • Seizures (uncontrolled convulsions)
  • Confusion
  • Changes in responsiveness

How to Prevent the Flu and Flu-Related Complications

To reduce the risk of a senior contracting the flu and developing serious complications, the National Council on Aging (NCOA) recommends that elders and their family members receive annual flu vaccinations. “Prevention is critically important,” urges Richard Birkel, PhD, former senior vice president of NCOA. “Unfortunately, vaccination rates are alarmingly low among older adults. Only about 59 percent of adults age 65 and older were vaccinated during the 2017-2018 flu season.”

The flu vaccine is updated each year based on data from a worldwide virus tracking system that helps public health officials predict which virus strains will circulate during the upcoming season. People age 65 and over have two vaccine options. There is a traditional flu shot and a higher dose flu shot designed specifically to address the age-related decline of the immune system. The higher dose vaccine prompts the body to produce more antibodies against the flu virus than would be produced by the traditional shot.

Because pneumonia is a common complication of the influenza virus, pneumococcal vaccines are also recommended for all adults over age 64. In addition to pneumonia, pneumococcal disease can cause dangerous infections of the bloodstream (bacteremia) and the linings of the brain and spinal cord (meningitis). Both influenza and pneumococcal vaccines are covered by Medicare Part B with no copay.