Possible Mechanisms of Late-Life-Onset Allergic Diseases and Asthma in the Senior Citizen

Ja, Bellanti; Azem, M; MacDowell-Carneiro, A L; Tutuncuoglu, S O; Wallerstedt, Dawn B.

doi:10.2500/108854100778248287

Cited by 12 publications

(18 citation statements)

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“…This may be due to concomitant age-related changes in nasal physiology in the elderly (nasal glandular atrophy, vascular changes, decreased nasal humidification, decreased mucociliary clearance, and structural changes of the nose) (7,8,10,23), which may contribute to more frequent rhinorrhea. In fact, it is likely that several mechanisms underlie the pathogenesis of rhinitis in the elderly, with potential interaction between inflammatory conditions and the influence of aging on nasal physiology (24).…”

Section: Discussionmentioning

confidence: 99%

“…The increase in life expectancy goes in parallel with a concern for better quality of life. Studies on allergic and respiratory diseases in geriatric populations have shown that allergens, infections, and irritants can be important triggers of inflammation, regardless of age-related physiologic changes in the immune system, connective tissue, and vasculature that may predispose for chronic rhinitis (6)(7)(8)(9)(10).…”

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confidence: 99%

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Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal

Morais‐Almeida¹,

Pité²,

Pereira³

et al. 2013

Allergy

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Background: Nationwide epidemiologic data on rhinitis in the elderly do not exist. This study aimed to estimate the prevalence of rhinitis in the population aged 65 years or above in mainland Portugal and to characterize and classify rhinitis in this age group. Methods: Cross-sectional, nationwide, population-based survey of citizens aged 65 years or above, living in mainland Portugal. Current rhinitis (CR) was defined as the presence of at least two symptoms: 'repeated sneezing and itchy nose', 'blocked nose for more than one whole hour', or 'runny nose when not having a cold or flu', either usually or in the last 12 months.Rhinitis severity was assessed using a visual analogue scale; rhinitis was classified according to ARIA. Results: Data were obtained from 3678 responders (92.5% response rate). The prevalence of CR was 29.8% (95% confidence interval (CI): 28.4%-31.3%): 49.1% had mild intermittent, 7.0% mild persistent, 27.5% moderate-severe intermittent, and 16.4% moderate-severe persistent rhinitis. Only 38.6% of patients with CR had been physician diagnosed and 38.7% were under treatment for this disease in the previous year. Allergic conjunctivitis symptoms were referred by 68.6% of subjects with CR (rhinoconjunctivitis population prevalence, 20.5% (95% CI: 19.2%-21.8%)). Conclusions: Rhinitis and rhinoconjunctivitis are common but underdiagnosed and undertreated diseases in the geriatric population. This was the first nationwide epidemiological survey classifying rhinitis according to ARIA guidelines in this age group. More than 40% of old-age patients presented moderate-severe disease.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal

Morais‐Almeida¹,

Pité²,

Pereira³

et al. 2013

Allergy

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“…In fact, although in their daily work allergists see more and more elderly patients with rhinitis, asthma and other allergic diseases, few studies have assessed the prevalence of atopy and allergic diseases in elderly patients with objective measures such as skin prick tests to aeroallergens or food allergens or serum IgE determination [2,3,4,5,6]. Because of changing world demographics, it is estimated that the elderly population will increase by 75% between 2010 and 2030 [7]. …”

Section: Introductionmentioning

confidence: 99%

Prevalence of Atopy and Respiratory Allergic Diseases in the Elderly SAPALDIA Population

Wüthrich

Schmid‐Grendelmeier²,

Schindler³

et al. 2013

Int Arch Allergy Immunol

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Background: Because of changing world demographics, the elderly population is steadily increasing. Few studies have assessed the prevalence of atopy and allergic diseases in elderly persons with objective measures. The aim of this paper is to describe the prevalence of atopy, self-reported allergic rhinitis and doctor's diagnosed asthma in persons over the age of 60 in Switzerland. Methods: The cross-sectional examination of the Swiss Study on Air Pollution and Health in Adults (SAPALDIA 1), performed in 1991, included 9,651 adults aged 18-60 years. In 2001-2002 the same subjects were invited for a follow-up examination (SAPALDIA 2). Serum samples collected at baseline and follow-up were tested for specific IgE sensitization with the Phadiatop® (Phadia, Uppsala, Sweden, now Thermo Fisher Scientific) assay containing a mixture of common respiratory allergens (grass, birch, mugwort, Parietaria and olive pollen, dog, cat, horse, Cladosporium herbarum, house dust mite and flour mite). Atopy was defined as a positive result in the Phadiatop test according to guidelines by the manufacturer. The prevalence rates of atopy, self-reported allergic rhinitis and doctor's diagnosed asthma were evaluated by sex and age group (≤60 or >60 years). Results: 7,667 subjects (men = 3,692/women = 3,975) participated in the follow-up by responding to a detailed questionnaire (80% of SAPALDIA 1 participants). Phadiatop results were available for 5,835 participants (men = 2,839/women = 2,996). Prevalence rates of atopy (Phadiatop positive) were 36.4% in men aged ≤60 years versus 26.2% in men aged >60 years and 30.6 and 18.1% in women, respectively (both p < 0.001). Prevalence rates of self-reported allergic rhinitis in subjects >60 years old were 13.0% for men and 15.4% for women (p = 0.12), and for doctor's diagnosed asthma 6.6% versus 7.6%, respectively (p = 0.40). Both rhinitis and asthma prevalences were higher in persons <60 years. The results were not sensitive to potential bias from nonparticipation at follow-up as demonstrated by imputation of sex- and age-specific allergic rhinitis and asthma among nonparticipants. Conclusions: According to our estimates, the prevalence of allergic rhinitis among persons aged between 60 and 70 years in Switzerland in the present cohort is of the order of 13-15% and should not be underestimated, although it is lower than in age groups ≤60 years.

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“…These include thymic involution, which may impact immune tolerance, decreased T-cell function and decreased T-cell response to growth factors [26]. Hum oral immune responses also change with age.…”

Section: Allergic Rhinitismentioning

confidence: 99%

Clinical Presentation and Management of Geriatric Rhinitis

Nocon

Pinto

2009

Aging Health

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The population of Americans over 65 years of age is growing at an unprecedented rate. Rhinitis is a common and burdensome complaint in this group, and physicians should be aware of the diagnosis and management of the disease. Geriatric rhinitis is a nasal disorder of older persons that presents with a constellation of nasal symptoms. The etiologies of this condition include both inflammatory diseases and the effects of aging on physiology of the upper airway. Possible causes include allergic rhinitis, nonallergic rhinitis (vasomotor rhinitis and gustatory rhinitis), adverse effects of medications, hormonal changes, postnasal drip syndrome, chronic rhinosinusitis and atrophic rhinitis. Nasal symptoms in the older patient present a clinical challenge because of the physiologic effects of the aging nose, the unusual clinical presentation, the presence of multiple comorbidities and the problem of polypharmacy. A number of therapeutic options exist for this disorder, although definitive studies of effective regimens are needed.

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Possible Mechanisms of Late-Life-Onset Allergic Diseases and Asthma in the Senior Citizen

Cited by 12 publications

References 0 publications

Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal

Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal

Prevalence of Atopy and Respiratory Allergic Diseases in the Elderly SAPALDIA Population

Clinical Presentation and Management of Geriatric Rhinitis

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