These diseases may be underdiagnosed and overlooked among seniors, who often develop them later in life.
As we get older, we expect to experience changes in our body commonly associated with aging such as thinning bones, hearing and vision loss, and arthritis. What we don’t expect is the onset of allergies and asthma. These are usually thought of as childhood diseases. However, allergies and asthma are commonly diagnosed for the first time in people who are 65 and older.
More Americans than ever are suffering from allergies, ranking this condition as the fifth leading chronic disease in the U.S. among all ages, according to the National Academy on an Aging Society. Each year, allergies account for more than 17 million outpatient office visits, primarily in the spring and fall; seasonal allergies account for more than half of all allergy visits, according to The Centers for Disease Control and Prevention, which estimates that 50 million Americans (that’s 1 in 5 Americans) suffers from allergies. Asthma affects more than 25 million people in the United States.
As common as these diseases are, they are often overlooked, underdiagnosed, and left untreated especially among the senior population, leaving many of us to suffer needlessly. Although there is no cure for allergies and asthma, there are many prevention strategies, treatments and lifestyle changes that can help us relieve symptoms, feel better, and live healthy and very active lives.
Allergies are diseases of the immune system that cause an overreaction to substances called allergens. Allergies are grouped by the kind of trigger, time of year or where symptoms appear on the body. There are indoor and outdoor allergies (also called hay fever, seasonal, or nasal allergies). There are food allergies, latex allergies, insect allergies, skin allergies and eye allergies. The most common allergens are tree, grass and weed pollen as well as mold spores, dust mites and cockroaches, according to the Asthma and Allergy Foundation of America. Cat dander is the most common pet allergy.
Many people have allergies to a medication, such as the group of antibiotics called penicillin. The most common signs of a drug allergy are hives, rash or fever. You may develop an allergic reaction to a drug, even if it caused no reaction in the past. Most allergic reactions occur within hours to two weeks after taking the medication. It is important to take all medications exactly as your physician prescribes. Call your doctor if you have side effects that concern you, or you suspect a drug allergy has occurred. If your symptoms are severe, seek medical help immediately.
Allergens enter our bodies in various ways. Either we eat them, breathe them into our lungs, inject them or touch them. This immune overreaction causes symptoms such as coughing, sneezing, itchy eyes, runny nose and scratchy throat. In severe cases it can also result in rashes, hives, lower blood pressure, difficulty breathing, asthma attacks, and even death. The good news is that allergies can be managed with proper prevention and treatment.
Asthma is a disease of the lungs in which the airways become blocked or narrowed causing breathing difficulty. Allergies and asthma often exist together. The same substances that trigger an allergic reaction may also cause asthma symptoms, such as coughing, shortness of breath, wheezing and chest tightness. Certain substances, such as pollen, dust mites and pet dander, are common triggers. In some people, skin or food allergies can cause asthma symptoms. Asthma may require hospitalization and can be life-threatening.
Having an indoor allergy puts us more at risk of having asthma. Indoor air pollution such as cigarette smoke, mold, and fumes from household cleaners and paints can cause allergic reactions and asthma. Environmental factors such as pollution, sulfur dioxide, nitrogen oxide, ozone, cold temperatures, and high humidity are all known to trigger asthma in susceptible people. In fact, asthma symptoms and hospital admissions are greatly increased during periods of heavy air pollution. Gas stoves are another potential trigger for asthma. Studies show that people who cook with gas are more likely to have wheezing, breathlessness, asthma attacks, and hay fever than those who cook with other methods, according to WebMD. Weather changes can also result in asthma attacks in some people. For instance, cold air causes airway congestion and an increase in mucus production. Increases in humidity may also cause breathing difficulty in some people.
Why Seniors are Susceptible
*Lifetime Load Theory
So what makes someone susceptible to developing allergies later in life? There are a number of reasons. First off, people who have lived a long life acquire a lot of possessions and keep those possessions around. This is something called the Lifetime Load Theory. Living amid a lifetime of possessions, such as favorite books and furniture, can sensitize you to allergy triggers in your environment, causing allergic reactions to allergy triggers that never bothered you before. Keeping your home clean and getting rid of unnecessary clutter can reduce the amount of mold and dust you breathe every day.
Secondly, physiological changes that naturally occur with age may trigger an allergy. For instance, the amount of water in the body generally decreases as we grow older, which in turn decreases the action of tiny hairs, called cilia, in the nose that help wash it out. There’s less blood flow to the nose as we get older, as well, which may dry passageways, produce more inflammation, and make a person feel stuffy. Then there’s cumulative damage to the nose, including polyps and bent cartilage, which may result in decreased nasal airflow and contribute to nasal obstruction complaints in geriatric hay fever (rhinitis) patients, according to an article published in the journal Allergy, Asthma & Clinical Immunology. The article also cites studies that show postnasal drip, nasal drainage, coughing, sneezing and nasal dryness increase with age, and that due to reduced hydration, older patients can have excessively thick mucus.
*Other theories as to why allergies occur later in life include being exposed to allergens when the immune system is weakened, such as during an illness, moving to a new location with different trees, plants, and grasses, as well as getting a pet.
Prevention and Treatment Strategies
Communicate with your doctor about the onset of any allergy- or asthma-like symptoms you may experience, even if you think they are related to a medical condition you already have. Your physician may refer you to an allergist who can better diagnose your condition and give you a treatment plan to help you manage your disease. When you visit your doctor, take a list of your medical conditions and all of the medications you take to avoid being prescribed drugs that will cause adverse reactions.
As you grow older, you tend to have more than one medical condition, and symptoms of some conditions overlap with allergy symptoms. These factors may make it more difficult for your physician to diagnose allergies. A tight chest, shortness of breath, cough and wheezing may be symptoms of congestive heart failure, chronic obstructive pulmonary disease or asthma.
In addition, medications taken for other medical conditions can have side effects that mimic allergies and asthma symptoms. Ace inhibitors used to treat coronary disease, diabetes and high blood pressure can cause a dry cough. Beta blockers taken to regulate blood pressure and glaucoma can constrict the airways in the lungs and cause or worsen asthma.
Once you’ve identified that you have an allergy and you know what allergens cause a reaction, try to remove them from your home, which may include doing a thorough cleaning to eliminate pollen and dust mites, switching out furniture, carpets and bedding for new hypoallergenic materials, and even finding a new home for a pet.
If you know you have certain allergies, reduce your exposure whenever possible. For instance, if you have outdoor allergies, such as to pollen, stay inside when the pollen count is high, especially in the morning, and keep windows closed and air conditioning on. The best time to go outside is after a good rain, which helps clear pollen from the air. Wear sunglasses or glasses when outside to prevent allergens from entering your eyes.
For asthma sufferers, quitting smoking and maintaining a healthy weight can go a long way in prevention or at least keeping the severity of symptoms to a minimum. Both cigarette smoking and obesity are linked with an increased risk for developing asthma. Also, overweight asthmatics seem to have more uncontrolled asthma and more days on medications for asthma.
Some over-the-counter products can help relieve symptoms. For instance, a ‘neti pot’ may be used to help wash allergens from the inside of the nose. If the allergen is removed, then there isn’t anything there to make the body react. Another fix that can bring great relief is a humidifier, particularly in the winter. Conversely, if mold, mildew, or dust mite allergies are making you miserable, a home dehumidifier may help. Inhalers are helpful in targeting seasonal allergies and wheezing. Antihistamines, including Zyrtec, Allegra, Clarinex and Claritin, as well as nasal steroid sprays, are popular products that offer relief. Allergy shots (also called immunotherapy) help the body get used to allergens, improve symptoms and reduce the amount of allergic reactions. Also, ask your doctor about anti-inflammatory drugs.
Be very cautious with over-the-counter medications, however, as many of them may cause hazardous side effects, such as dizziness, drowsiness, memory impairment, and confusion, or exacerbate other conditions such as heart disease. These side effects may be particularly dangerous for seniors who may already be on a number of medications to treat one or multiple chronic conditions and are at risk for falling or medication mismanagement.
We can’t stress enough to you the importance of consulting your doctor if you think you have allergy or asthma symptoms. Many seniors make the mistake of assuming that the symptoms they are suffering from are a natural part of aging or a side effect of a chronic disease and can’t be helped. There are many treatment options available. Getting the proper care for allergies and asthma can dramatically improve your health, comfort and quality of life.