On 27 Dec, 2025, Senior Today hosted their weekly Health Live Webinar with Dr Aditya Agrawal, leading Pulmonologist who spoke on and answered questions about Seasonal Cough and Respiratory Concerns for Seniors.
About Dr Aditya Agrawal
Dr Aditya Agrawal is a leading Consultant Pulmonologist attached to several large hospitals in Mumbai. He is extensively trained in respiratory diseases both in India and the US. His special interests are in difficult-to-treat cough, asthma, bronchitis and lung fibrosis, and runs a specialised clinic for patients with chronic cough. He is a dedicated researcher and a peer influencer in the management of respiratory diseases.
Seasonal cough and respiratory ailments in the elderly is a phenomenon that the entire country is dealing with at present.
Ageing lungs are definitely weaker. They are less elastic ie they do not open and close as efficiently as when you were younger.
As we age, our lungs keep getting smaller.
As we age, our lungs are not able to cough out the mucus which is produced in the lungs as you age. You may have realised that as you age your cough tends to get stuck in your chest, leading to congestion more often than when you were younger.
As winters approach, the pollutants cling very close to the surface of the earth. The particulate matter of size 2.5 micron and 10 micron tends to stay on the surface of earth. Therefore along with the air that you breathe, you also breathe these particulate matters which affect your lung.
The shape of your lung is such:
A large windpipe which appears like an inverted tree- a tree trunk with branches which keep getting smaller as smaller. The lung tubes branch out 23 times. By the time you reach the end of your lung you have small spaces called alveoli.
It is the alveoli that is the particular matter between the sizes of 2.5 to 10 micron deposits. From your alveoli, these are absorbed into your blood as well, reaching every corner of your body. This increases your risk for diseases such as asthma, pneumonia. You may also develop the complaint of wheezing, and if you already have a compromised lung, you may develop attacks/ exacerbation of COPD/ asthma.
These are more common in urban India and Northern parts of India where the effects of pollution are far more than our Southern counterparts.
Normally, when you breathe, the airways in your lungs are open. The minute you are exposed to cold air your lungs in an attempt to protect themselves constrict and become narrow, thereby disallowing air from going out of your lungs.
The pollution and fumes in the lungs too triggers the airways and constricts the tubes in the lungs, making them narrower. The pollution does not only affect your lungs, it impacts every organ of your body- heart, brain and lungs.
When these particles enter your lungs they cause inflammation/ injury which causes the body to react and become diseased which in turn signals several receptors and chemoreceptors in the body signalling a situation of stress. This enters your body into a fight mode which causes release of chemicals such as glucocorticoids in your body which cause your blood vessels to constrict, heart rate to increase and raise blood glucose levels.
Air pollution causes systemic inflammation ie every part of your body becomes swollen, diseases, red. It also causes an increase in the incidence of high blood pressure.
Air pollution causes neuroinflammation ie increase injury in your brain which can also result in strokes or cardiovascular disease.
Common winter issues found in our Seniors:
- Cough: it is not a seasonal phenomenon. Seasonal cough is not a disease, it is a manifestation of multiple diseases.
- You may have a dry cough or a productive cough
- Dry cough can be due to asthma, cold, acid reflux, sleep apnoea, loose vocal cords, allergies
- Wet/ productive cough can be caused due to cold, infection, more serious infection in the lung, COPD, chronic bronchitis
- If you have cough, you need to see your doctor to identify the cause for your cough and adequate treatment
- Upper Respiratory Tract Infections (URTIs): they tend to peak during winters.
- Influenza/ flu infections start rising in the month of December and peak during the month of January and start going down by the month of March.
- Influenza progresses faster in older adults. Men and women over the age of 60 have a poorer outcome than when they were younger
- COPD/ Chronic Bronchitis: these are extremely sensitive to cold and smoke. This leads to an increase in the amount of coughing, sputum production, risk of wheezing and number of hospital visits in the winter months.
- Asthma worsens in cold and dry pollutant air. It causes severe spasms in the chest resulting in tightness of the chest resulting in increased number of puffs required with the help of their inhalers and increased breathlessness.
Indoor air pollution is also a major factor for disease exacerbation in the elderly who tend to stay at home more often than the younger people.
Indoor air pollution can be caused by:
- Release of chemicals which are used in paint coatings
- Cleaning agents
- Carbon dioxide from your garage where your vehicle is getting warmed up in a closed space.
- Dust, germs, etc.
- Use of aerosols such as incense sticks, mosquito coils, tobacco smoke, cooking smoke, etc.
The elderly who are breathing polluted air, often have one/ more of the following complaints:
- Cough
- Breathlessness
- Chest tightness
- Drowsiness- as the level of carbon dioxide increases
- When the level of carbon dioxide levels increase more than 5000 ppm, it is unsafe for a person to continue staying in that space/ place
Recurrent winter bronchitis and chronic production of phlegm can be an early warning sign of an underlying disease such as chronic bronchitis, COPD, bronchiectasis, heart disease. These should be bright into the notice of your treating doctor.
Lung cancer is increasing with an increase in the duration of exposure to tobacco smoke and air pollution. Such patients may have:
- Persistent cough which does not go away with treatment
- Weight loss
- Blood in sputum
Individuals with pre existing heart disease, kidney disease and diabetes have poor respiratory health i.e. they have poor lung health throughout winters due to weaker immune response.
