Some older adults might find their allergies get worse with age. This may be due to a decline in organ function and the development of long-term health conditions.
An allergic response occurs when a person’s immune system has a hypersensitive reaction to a substance that does not usually produce this reaction in most individuals. These substances are called allergens.
Older adults are susceptible to the same allergens that can affect individuals of any age. These may include food, medications, insect bites, and environmental substances such as pollen. Allergic reactions can involve the skin or the respiratory system, which includes the lungs, nose, and breathing passages.
This article discusses how allergies may worsen with age, including the causes, types, and treatment.
The prevalence of allergies is growing. This may be related to how factors such as improved hygiene, modern diets, or air pollution affect the body’s microbiota, which helps regulate the immune system and its tolerance of allergens.
That said, in older adults in particular, allergies may increase with age. This is because the aging immune system, known as immunosenescence, can play a role in allergy development, affecting how microbiota responds and contributing to inflammation. Various age-related health conditions can also impact how allergies develop and manifest in older age.
Generally, the immune system can lose some function with age. Along with that, certain underlying medical conditions may co-occur with allergies in older age, such as atopic dermatitis (eczema) and untreared asthma.
Additionally, in older individuals, there can be a shift from
Allergies that may get worse with age include:
- Food allergies: Until recently, doctors considered food allergy a condition that predominantly affects children. However, the incidence in all ages is rising worldwide, affecting even older adults, according to a
2019 review . - Drug allergies: Reactions to medications may occur more in older adults simply because the incidence of medication use
rises with age . Some of these negative reactions may be allergic. While drug allergies in this age group are not well-studied, estimates suggest they affect 0.6 to 2.1% of older adults. - Hay fever: Physiological and anatomical changes in the nose, such as weakening of the septum, can 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.
- Asthma: Asthma is a lung condition that
can be associated with allergies like hay fever. Factors that can worsen asthma with age include a progressive decline in lung function and weakening of breathing muscles. - Skin allergies: As people age, their skin can lose hydration, become dry, and be more prone to allergic reactions. Triggers include dust mites, pollen, and food.
- Anaphylaxis: Anaphylaxis can be potentially life threatening and can affect people of all ages. But older adults may be particularly vulnerable to severe anaphylaxis due to risk factors like underlying health conditions. In older age, anaphylaxis seems to be most associated with insect bites and drug allergies.
Anaphylaxis: Symptoms and what to do
Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:
- hives
- swelling of the face or mouth
- wheezing
- fast, shallow breathing
- a fast heart rate
- clammy skin
- anxiety or confusion
- dizziness
- vomiting
- blue or white lips
- fainting or loss of consciousness
If someone has these symptoms:
- Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
- Dial 911 or the number of the nearest emergency department.
- Assist the person in moving from a sitting position to lying down. If they have vomited, turn them onto their side.
- Stay with them until the emergency services arrive.
Some people may need more than one epinephrine injection. If the symptoms do not improve in 5 to 15 minutes, or they come back, use a second pen if the person has one.
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, treatment and management generally focuses on allergen avoidance, immunotherapy, and medications. However, research hasn’t shown that medication can alter the natural progression of allergic conditions in the long term. As a result, older adults dealing with allergies might find themselves adding more medications to their routine for symptom relief.
In addition, 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.
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.
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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.