Having a sinusitis attack is not a matter to be taken lightly if you are elderly. Not only can it cause great discomfort because of constant nasal discharge and nasal congestion, complications may arise.

“Older people with sinusitis are at higher risk of developing more serious upper respiratory tract infections because of their lower immunity,” says Dr Constance Teo, Consultant at the Department of Otolaryngology, Singapore General Hospital (SGH), a member of the SingHealth group.

Rhinitis and chronic sinusitis are two of the most common sinus infections to affect older people due to age-related nasal physiological changes, Dr Teo continues. Rhinitis and sinusitis frequently occur together.

Risk of sinusitis in an ageing person

As one ages, the capacity of an ageing nose to produce mucus is reduced as the mucus membranes lining the nose (nasal mucosa) become thinner.

Poorer blood circulation to the nasal lining also results in less humidification of the air passing through the nose, resulting in nasal dryness.

Furthermore, in the elderly, the clearance of the mucus from the nose is less efficient. “The combination of a thick mucus which the body is unable to clear efficiently together with the lower immunity results in a higher risk of sinusitis in the elderly,” says Dr Teo.

Rhinitis and sinusitis

Rhinitis is an inflammation of the nasal mucosa or membranes that line up the inside of the nose. Main symptoms can include a dry, irritated nose and crusting of the mucus in the nose.

Unlike rhinitis, sinusitis is an inflammation of the paranasal sinuses. These are the hollow spaces in the bones around your nose, on the forehead, behind and between the eyes, and at the back of the nasal cavity.

If rhinitis is not treated adequately, it can lead to chronic sinusitis - a prolonged sinus infection that can take weeks or months to resolve.

Due to the proximity of the sinuses to the eye and the brain, there is a potential risk of the infection spreading to these areas if it is not treated promptly.

Extra precautions when treating sinus problems in the elderly

Firstly, as older people are likely to have various chronic health conditions, they need to be aware of possible drug interactions between existing medications (e.g. drugs for heart problems) and sinus medications. For instance, decongestants may trigger faster heartbeat.

Secondly, certain over-the-counter medications used to relieve nasal congestion and nasal discharge could worsen nasal dryness and crusting of the mucus in older people with rhinitis.

Thirdly, besides sinus problems, tumors of the nasal cavity or sinus can have similar symptoms which may be difficult to differentiate without specialist assessment.

“Seek proper medical treatment for your sinus problems if you are a senior, especially if you are taking medications for high blood pressure and heart problems,” advises Dr Teo.

Ref. T12