Choking on water is common in the elderly, but it is not a problem with the lungs. Instead, one should consider the possibility of "lacunar infarction." This condition has a high incidence rate among the elderly and is a type of cerebral infarction. It is caused by the occlusion of small, deep cerebral arteries due to hypertension, small arteriosclerosis, or embolic detachment. However, because the diameter of the infarcted blood vessels is typically less than 2 millimeters and often occurs in areas detectable only by CT and MRI, "lacunar infarction" is frequently overlooked. This infarction often damages the glossopharyngeal and vagus nerves, and one of its most typical manifestations is frequent choking while drinking water.
In addition, there may be sensory abnormalities on one side of the body, such as numbness, burning, stabbing pain, heaviness, or stiffness. These mostly occur in the face and upper limbs but can also be a sensory disturbance on one side of the body, such as numbness in the right arm and right leg simultaneously. There may also be varying degrees of paralysis in the face, tongue, and limbs, or a tendency to frequently bite the tongue.
Although the symptoms of lacunar infarction can be mild and sometimes transient, they should not be taken lightly because they serve as an important warning sign that the patient is at risk for cerebrovascular disease. It is crucial to go to the hospital immediately for a doctor to assess the risk of future vascular infarction and prescribe medication accordingly, such as antithrombotic and antiplatelet therapy. In short, the cause of the elderly person's choking must be identified. First, this is to prevent the formation of larger blood clots. Second, frequent choking on water and food can lead to aspiration pneumonia. The physical responses of the elderly are often slower and weaker, and many people develop aspiration pneumonia without even realizing it. This type of pneumonia is often a reason for severe illness or even death in the elderly, as the infection can be very difficult to control. This risk is especially high for those who are already less mobile and frequently bedridden, as their risk of developing pneumonia is increased to begin with, and frequent choking exacerbates this risk.