Allergic Diseases in the Elderly

Clinical Features of Allergic Diseases in the Elderly

Most common allergies dealt with the elderly people include:-

1. Allergic Rhinitis

• Patients typically present with sneezing, pruritus and nasal congestion.
• Reduction of blood flow to the nose can lead to progressive nasal atrophy and clinical manifestations of atrophic rhinitis, and thinning and dryness of the mucosa make the elderly especially prone to rhinitis.

2. Asthma

• Frequently in old people asthma remains underdiagnosed and the percentage increases when respiratory symptoms are present.
• The severity of Asthma strongly correlates with increased reactive oxygen species (ROS) levels which contribute to the airway inflammation. Thus, asthmatic symptoms related to oxidative stress in aged patients may be significantly affected by age-associated ROS. Additionally, oxidative stress and the resulting cellular modifications are prevalent in asthmatic patients during aging.

3. Cutaneous Allergic Conditions

• Clinically, aged skin is characterized by atrophy, wrinkling, fragility, alterations in pigmentation, a higher frequency of benign and malignant tumors, and a greater tendency to xerosis. Altogether, these factors contribute to greater susceptibility to dermatologic diseases and pruritus, the most common skin complaint in patients over the age of 65 years, frequently associated with dry skin.
• Atopic dermatitis is much less common in the elderly compared with children and young adults. It is associated with seasonal mucosal allergies, asthma and positive prick tests to various allergens. 
• Urticaria (with or without angioedema), especially chronic spontaneous urticaria, is quite common in elderly patients. Systemic diseases that may induce urticaria should be ruled out.

4. Food Allergy

• Regarding clinical manifestations, anaphylaxis is less common in older patients.

5. Drug Allergy

• Adverse drug reactions (ADR) are very common in frail elderly, cause clinically significant morbidity and mortality, the use of large numbers of medications by older patients increases the likelihood of harmful drug interactions, adverse drug reactions and drug allergies.