The spectrum of chronic obstructive pulmonary disease presentation in geriatric populations: A comprehensive review

Chronic obstructive pulmonary disease (COPD) presents unique clinical challenges in elderly populations, where age-related physiological changes and multiple comorbidities complicate diagnosis and management. Elderly patients typically present through four distinct patterns: characteristic respiratory symptoms, non-respiratory complaints, comorbidity-related manifestations, or acute exacerbations. Cardinal symptoms include dyspnea, chronic cough, sputum production, wheezing, and chest tightness, though presentation may be atypical with predominant systemic features such as cognitive impairment, falls, or weight loss. Physical examination findings reflect disease severity and complications, including accessory muscle use, barrel chest, pursed-lip breathing, and signs of hypercapnia or cor pulmonale. Diagnostic challenges arise from symptom attribution to normal aging, overlapping comorbidities, and cognitive impairment affecting symptom reporting. Comprehensive assessment incorporating functional status evaluation and recognition of circadian symptom patterns is essential for optimal management. Understanding these diverse clinical presentations enables earlier diagnosis and individualized treatment approaches in this vulnerable population.