Cough in the Elderly Population: Relationships with Multiple Comorbidity

BACKGROUND: The epidemiology of cough in the elderly population has not been studied comprehensively. The present study aimed to investigate the epidemiology of cough in a community elderly population, particularly in relation with their comorbidity. METHODS: A cross-sectional analysis was performed using a baseline dataset from the Korean Longitudinal Study on Health and Aging, a community-based elderly population cohort study. Three types of cough (frequent cough, chronic persistent cough, and nocturnal cough) were defined using questionnaires. Comorbidity was examined using a structured questionnaire. Health-related quality of life was assessed using the Short Form 36 questionnaire. RESULTS: The prevalence was 9.3% for frequent cough, 4.6% for chronic persistent cough, and 7.3% for nocturnal cough. In multivariate logistic regression analyses, smoking, asthma and allergic rhinitis were found to be risk factors for cough in the elderly. Interestingly, among comorbidities, constipation and uncontrolled diabetes mellitus (HbA1c ≥ 8%) were also found to have positive associations with elderly cough. In the Short Form 36 scores, chronic persistent cough was independently related to impairment of quality of life, predominantly in the mental component. CONCLUSIONS: Cough has a high prevalence and is detrimental to quality of life in the elderly. Associations with smoking, asthma and rhinitis confirmed previous findings in younger populations. Previously unrecognised relationships with constipation and uncontrolled diabetes mellitus suggested the multi-faceted nature of cough in the elderly

Cough sounds

Cough is an important protective reflex that is essential to protect the airways yet can also signify disease as a symptom of airway disease. It is the most common symptom that results in new medical consultations at least in regions where data is available. Both children and adults can cough for a myriad of reasons. This ranges from cough associated with simple viral infections to cough secondary to serious airway or lung disorders. Consequently evaluating causes of cough can be quite challenging. The mechanism of cough involves the central and peripheral neural systems, muscular and airway mechanisms. The sound of cough is influenced by various physiological factors such as age and sex and by pathological factors such as muscle weakness, airway obstruction and excessive mucus production. This chapter briefly reviews factors influencing cough sounds and recorders. As cough is a cardinal symptom of airway diseases and many respiratory illnesses, a description of typical cough quality in various respiratory conditions is provided. We also briefly discuss the availability and developments in software, apps and cough measurement devices that unfold a new exciting field of study and research in our era of advancing technology