Can allergies get worse with age?

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A 2017 review notes that there is little research into the prevalence of allergies in older adults. However, due to factors associated with aging, allergies have the potential to worsen as people get older.

Multiple factors contribute to the increased vulnerability of older adults to allergies. The authors of the review above explain that aging causes anatomical changes and a decline in the functioning of multiple organs, including the following:

• gut
• skin
• respiratory system
• immune system

People in this age group also tend to develop more chronic — or long-term — conditions, which may influence their response to an allergen.

These can include the following:

Food allergies

Until recently, doctors considered food allergy a condition that predominately affects children. However, the incidence in all ages is rising worldwide, affecting even older adults, according to a 2019 review.

The higher risk of food allergies in this age group stems from:

• atypical functioning of the immune system, which can result in elevated inflammation
• increased permeability in the intestinal tract, meaning more substances may pass from the intestines into the rest of the body
• negative changes in the gut microbiota, which can negatively affect the immune response and increase inflammation
• more deficiencies in antioxidants and nutrients the immune system needs for typical functioning

Drug allergies

Another 2017 review states that older adults have a higher risk of drug-related issues, most of which stem from side effects of medications rather than allergic reactions.

No adequate studies have determined the prevalence of drug allergies in older adults, but it is possible to estimate that it ranges from 0.6 to 2.1%. Some of these allergies are serious, as they comprise as much as 10% of fatal drug reactions.

The below factors underlie drug-related issues due to side effects, not allergies:

• more coexisting chronic conditions
• use of multiple prescription and over-the-counter medications that may interact
• memory difficulties

Hay fever and asthma

An older 2011 review states that physiological and anatomical changes in the nose, such as weakening of the septum, occur due to aging. This may worsen symptoms of hay fever that occur when people experience a hypersensitive reaction to pollen or other environmental substances they are exposed to.

Symptoms of hay fever may include:

• runny nose
• nasal congestion
• cough

Evidence indicates that other changes due to aging may worsen asthma. These may include a progressive decline in lung function and weakening of breathing muscles. Asthma symptoms may include wheezing and difficulty breathing, although other age-related conditions may cause them, too.

Skin allergies

As people age, the skin loses hydration and becomes dry. According to research, this can make a person more susceptible to allergic reactions in the skin.

Triggers of skin reactions may include various substances, including:

• dust mites
• pollen
• food

The frequency of rashes in older adults is gradually rising as society ages.

Anaphylaxis

Anaphylactic reactions can be potentially life threatening. Older adults may be particularly vulnerable to severe anaphylaxis due to certain risk factors, such as having co-occurring health conditions.

Still, anaphylaxis can affect people of all ages. Some symptoms of anaphylaxis include:

• difficulty breathing
• fast heart rate
• swelling of the lips or face
• fainting

Triggers may include food, medications, and insect bites.

As people age, they are less able to cope with anaphylaxis because of conditions that affect the heart and blood vessels, such as:

• high blood pressure
• high blood pressure medications that would hinder the actions of the body to counter the anaphylaxis
• irregular heartbeats

Treatment depends on the type of allergy but does pose a greater challenge in older adults. First, diagnosing the allergy and differentiating it from other conditions may be difficult and delay treatment.

Once a doctor diagnoses an allergy, co-occurring conditions and ongoing medications may limit treatment options. These factors can cause harmful effects on the allergy itself or lead to negative interactions with allergy medications. More research is necessary to determine optimal allergy treatment for older adults.

The aforementioned 2017 review suggests that regular exercise may reduce allergies. It improves the following, which can influence the body’s response to an allergen:

• immune function
• heart and lung function
• muscle strength

If an individual experiences symptoms of anaphylaxis, they should call 911 for emergency treatment.

As treating older adults for allergies presents difficulties, if a person experiences symptoms, they should consult a specialist. This can include speaking with an allergist or a dermatologist.

Someone’s primary care doctor may direct them to a specialist with the needed expertise.

Allergies getting worse with age is one of the difficulties that older adults may encounter. Older adults tend to have more chronic conditions and experience a decline in the functioning of several organs, both of which can heighten an allergic response.

Aging can potentially worsen any allergy, including hypersensitivities to food, medications, insect bites, and pollen.

Treatment options are more limited in older adults than in those who are younger, as allergy medications may negatively interact with ongoing medications. Such treatment may also have an adverse effect on existing chronic conditions.

A person with allergies may wish to consult a specialist, but someone with symptoms of an anaphylactic reaction should call 911.