摘要老年肺炎起病隐匿，临床表现和辅助检查缺乏特异性，需要结合高危因素进行综合判断。由于合并基础疾病多，多种合并用药给老年肺炎的诊治增加复杂性。分子生物学检测技术在老年肺炎病原诊断中具有重要地位，但需要根据应用指征、结合临床特点进行正确解读。早期精确诊断对于改善老年肺炎预后具有重要意义。

abstractsIn elderly patients, the onset of pneumonia is often subtle and typical respiratory symptoms are less common. Instead, non-specific presentations such as altered mental status and loss of appetite should be closely monitored. The sensitivity of chest X-rays and routine laboratory tests is often low, so a comprehensive assessment including risk factors is required. The presence of multiple comorbidities, including chronic respiratory disease, cardiovascular disease, and diabetes mellitus, is prevalent in this population and complicates early diagnosis. Polypharmacy further adds to the diagnostic and therapeutic challenges. Due to difficulties in specimen collection, high risks associated with invasive testing and atypical pathogen distributions, conventional microbiological detection methods often fail to meet clinical needs. Nucleic acid testing techniques, such as metagenome next-generation sequencing, offer a rapid and sensitive alternative for detecting a wide range of pathogens, including those not identified by conventional methods, as well as rare, multiple, or mixed infections. This approach also has the advantage of not being influenced by prior antibiotic use, making it a crucial role in diagnosing pneumonia in the elderly. However, it is imperative to select appropriate and high-quality specimen types and to interpret the results accurately, taking into account the clinical context and indications for testing. Timely and precise diagnosis is essential to improve the prognosis of pneumonia in elderly patients.