Why is aspiration a greater concern as a complication of EN in older adults?

• A. It is more common
• B. It causes no symptoms
• C. It is easily treated
• D. It can lead to pneumonia or death

Answer: (D)

Aspiration is especially worrisome in older adults on enteral nutrition because when the lungs are exposed to fed material or gastric contents, the consequence can be pneumonia or death. As people age, swallowing problems, reduced airway protection, and common comorbidities such as chronic lung disease and malnutrition increase the risk that material entering the stomach via a feeding tube will reach the lungs and trigger infection or inflammation. The elderly often have a diminished immune response and less physiological reserve, so infections like pneumonia can develop more rapidly and be harder to treat, with higher mortality. Feeding practices, such as degrees of head-of-bed elevation, timing, and tube placement, also influence the chance of aspiration, but the critical point is the potential progression to pneumonia or death, which makes aspiration a much more serious concern in this population.