Sore throat in older adults

Overview

A sore throat is pain, scratchiness, or irritation of the throat that often gets worse when you swallow. In older adults, it can be a sign of an infection or other health issue.

Yes, sore throat is common in older adults, though not as frequent as in children. It often occurs during cold and flu season.

Adults aged 65 and older are affected, especially those with weakened immune systems, chronic health conditions, or who live in care facilities.

Symptoms

Common symptoms

• Pain or scratchy feeling in the throat
• Worse pain when swallowing or talking
• Red or swollen tonsils
• Hoarse voice

Symptoms in children

• Fussiness
• Drooling more than usual
• Refusing to eat or drink

Symptoms in older adults

• Dry or scratchy throat even without pain
• Difficulty swallowing solid foods
• Unexplained hoarseness
• Lower fever or no fever compared to younger adults

Causes

Main causes

• Viral infections like the common cold, flu, or COVID-19
• Bacterial infections such as strep throat (less common in older adults)
• Irritants like dry air, smoke, or allergies
• Acid reflux, where stomach acid flows back into the throat

Risk factors

• Weakened immune system due to age or illness
• Smoking or exposure to second-hand smoke
• Living in close quarters like a nursing home
• Having a chronic condition like diabetes or heart disease

When to see a doctor

See a doctor urgently if:

• Trouble breathing or severe pain
• High fever that does not improve
• Unable to swallow any liquids

Book a routine appointment if:

• Sore throat lasting more than a week
• Recurrent sore throats several times a year
• Unexplained hoarseness lasting two weeks or longer

Diagnosis

Your doctor will ask about your symptoms and look at your throat with a light. They may also feel your neck for swollen glands.

Tests that may be done

• Rapid strep test: a quick swab of the throat to check for strep bacteria
• Throat culture: a swab sent to a lab to confirm the cause

What to expect at your appointment

The exam is simple and usually painless. The doctor may gently press on your tongue and swab the back of your throat. Results may be available in a few minutes or take a day or two.

Treatment

Treatment depends on the cause. Viral sore throats get better on their own; bacterial ones may require antibiotics. Your doctor will recommend the safest approach for you.

Self-care at home

• Rest your voice and drink plenty of warm fluids like tea or broth
• Gargle with warm salt water (half teaspoon salt in a glass of warm water) a few times a day
• Use a humidifier or breathe in steam from a hot shower to moisten the air
• Suck on ice chips or sugar-free hard candies (if you have diabetes, check with your doctor first)
• Avoid smoke and other irritants

Medical treatments

For pain, over-the-counter pain relievers like paracetamol (acetaminophen) can help. If a bacterial infection is confirmed, your doctor may prescribe antibiotics. Do not take leftover antibiotics from previous illnesses.

When is surgery considered?

Surgery is rarely needed for a simple sore throat. In very rare cases, an abscess (a pocket of pus) may need to be drained, but this is uncommon in older adults.

Living with this condition

While you recover, take it easy. Drink enough fluids to keep your throat moist and swallow comfortably. You may need to eat softer foods for a few days.

Lifestyle tips

• Avoid smoking and second-hand smoke
• Use a humidifier in your bedroom, especially in dry climates
• Wash your hands often to avoid spreading or catching infections

Diet and exercise

Eat soft, easy-to-swallow foods like yoghurt, applesauce, or scrambled eggs. Avoid spicy or acidic foods that can irritate your throat. Stay hydrated with water or herbal tea. Gentle exercise like walking is fine if you feel up to it.

Mental health and emotional wellbeing

Having a sore throat can be uncomfortable and frustrating, especially if it lasts a while. It may affect your appetite and sleep. Talk to your doctor if you feel anxious or down during recovery.

Prevention

You cannot always prevent a sore throat, but you can lower your risk with good hygiene and avoiding irritants.

Vaccines

Getting the yearly flu vaccine and the COVID-19 vaccine can help prevent viral infections that often cause sore throats. Ask your doctor about the pneumonia vaccine if you are 65 or older.

Screening programmes

There is no routine screening for sore throat itself. See your doctor if you have recurrent sore throats to check for underlying causes.

Complications

If left untreated

• Spread of infection to the ears or sinuses
• Formation of an abscess (a pocket of pus) near the tonsils
• Difficulty breathing if the throat swells severely

Long-term outlook

The outlook is very good. Most sore throats in older adults clear up within a week or two with home care. If treated promptly for bacterial infections, complications are rare. Stay in touch with your doctor and seek help early if symptoms worsen.

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