Infections in the elderly

Kent B Crossley

Research output: Chapter in Book/Report/Conference proceedingChapter

1 Scopus citations

Abstract

Although virtually all significant types of infections that occur in the elderly are discussed elsewhere in this book, certain aspects of infectious diseases in older individuals need to be emphasized. This chapter stresses the unique aspects of the etiology and therapy of infections in the elderly (defi ned here as older than 65 years of age). Infections that occur in longterm care institutions are briefl y discussed. For several reasons, infections in the elderly are an important area of concern for medicine. The number of individuals who are older than 65 is increasing dramatically. Although representing only 13% of the U.S. population at present, the elderly consume 25% of all prescription medications and a similarly disproportionate amount of other health care services. Moreover, with few exceptions (some viral infections and venereal diseases), most common infections occur more often in older individuals. Although the mortality associated with many infections is increased in the elderly, age alone is now seen as a relatively unimportant risk factor for infection-related death or serious morbidity. Rather, it is the variety of comorbid conditions that are increasingly common with advancing age that appear to be closely associated with greater morbidity and mortality from infection. Since the early 1990s it has become clear that there is a general hyporesponsiveness of the immune system in elderly individuals. This is the most likely explanation for the muted symptoms and signs that are a common denominator of infections in the aged. It is well documented in a number of types of infectious illnesses that maximum temperatures, white blood cell count elevations, and the overtness of clinical signs and symptoms are all less pronounced in older individuals than in younger adults. In clinical terms, this means that an elderly patient may have a serious bacteremic infection without chills, fever, or leukocytosis. This is one of the most important things to remember about infections in the aged.

Original languageEnglish (US)
Title of host publicationClinical Infectious Disease
PublisherCambridge University Press
Pages643-646
Number of pages4
ISBN (Electronic)9780511722240
ISBN (Print)9780521871129
DOIs
StatePublished - Jan 1 2010

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