Hillary Clinton, unable to walk, staggering, supported by bodyguards, literally hoisted into a van.
These images filmed in 2016, in the middle of the presidential campaign in the United States had toured the world and had been devastating for the candidate.
The 68-year-old politician suffered from pneumonia.
This inflammation of the lungs, usually caused by a viral or bacterial infection, can strike at any age.
In poor countries, it is known to be the leading cause of death in children under 5 years old.
But, in industrialized countries, it is especially formidable for the oldest.
Thus, at 100, it is no longer cancer that must be feared, but rather pneumonia.
At this age, the main certified causes of death are indeed old age or pneumonia,
Plos One
in 2014.
Why are the over 65s the most vulnerable?
In France, 90% of the 10,000 annual deaths from pneumonia are over 65 (apart from the coronavirus pandemic).
A fragility that has several causes.
"First of all with age, there is an alteration in the immune defense functions of the lungs"
, explains Professor Bruno Housset.
This is what specialists call immunosenescence, which we heard a lot about during the Covid-19 pandemic.
But, the mechanical defenses of the lungs are also reduced.
“In particular, there is a decrease in the effectiveness of the cough.
To cough, you need a violent effort to expel air and secretions.
However, as you age, the bronchial cartilages compress when you cough and will crush the bronchi.
The evacuation of mucus, which allows germs to be evacuated, is less successful”
, continues Professor Bruno Housset.
Added to this are problems of false roads when swallowing.
"It is then the bacteria present in the mouth, which can cause lung infections"
, explains Dr. Olivier Leleu pulmonologist at the CH d'Abbeville.
Pneumonia begins abruptly, with “stabbing” chest pain and high fever (over 40°C)
Another danger is the delay in diagnosis.
In its typical form, pneumonia begins suddenly, with “stabbing” chest pain and high fever (over 40°C).
“In older people, the symptoms are often atypical: there is no chest pain and the fever is lower.
In addition, the blood marker of inflammation, CRP, is often low in the early phase,”
explains Dr. Olivier Leleu.
A diagnostic difficulty that can lead to a delay in treatment.
“However, we must put patients as quickly as possible on antibiotics because the longer we delay, the higher the mortality,”
he continues.
Finally, from the age of 65, it is not uncommon to suffer from other illnesses, such as heart failure or chronic obstructive pulmonary disease, which weaken people.
"Undernutrition, common among older people, is also an important factor of fragility",
recalls Olivier Leleu.
An episode of infection such as pneumonia aggravates existing illnesses and alters the general condition.
"We have people whose episode of acute pneumonia evolves favorably but who in the following months will die because they decompensate diabetes, heart failure, kidney failure... These deaths are indeed the consequence of their lung infection",
explains Dr. Olivier Leleu.
The solution: get vaccinated and vaccinate those around you
The first effective vaccine to prevent pneumonia is the flu vaccine.
And now, the one against the coronavirus.
It is a question of vaccinating the oldest, but, as the vaccine is less effective in them, it is also important to immunize those around them.
Should I also be vaccinated against pneumococcus?
"It is recommended for all immunocompromised people or those suffering from a disease predisposing to the onset of a pneumococcal infection",
specifies Professor Bruno Housset.
The list is long: diabetes, heart failure, asthma, COPD…