As we age our immune system becomes inefficient in protecting us from disease, cancer, developing auto-immune disorders and healing wounds. This is known as “immunosenescence” – meaning the gradual deterioration of immunity due to natural aging. Survival depends on a functioning immune system able to defend the body against the continuous onslaught of organisms and pathogens and the ability to heal.
Due to advances in nutrition and medicine life expectancy has increased from what it was years ago, when people died at around aged 40 years, to an average of 80 years being now the norm. Immunosenescence begins at around age 60, so it is unsurprising the decline in health which affects seniors.
Aging immunity
Aging immunity is associated with a decline in protective immunity, but also with an increase in inflammatory disorders. Not only does aging lead to greater chance of infection, poor wound recovery and malignancies but also can mean an -
- Increased susceptibility to inflammatory diseases. Inflammatory responses mediated by the innate immune system and inflammation are greater and have a longer duration to resolution. This leads to inflammation and tissue damage and an increase in inflammatory disorders such as cardiovascular disease, Alzheimer’s disease, Parkinson’s disease and osteoarthritis.
- Reactivation of chronic viral infections – such as shingles for example.
- Chronic debilitating diseases can become accelerated or worsen – for example a predisposition for infection for sufferers of respiratory diseases.
- Auto-immune disorders. The immune system becomes less able to distinguish self from nonself which result in autoimmune disorders such as rheumatoid arthritis (RA).
- Vaccine response by the body can become impaired. Meaning vaccinations against diseases might not work.
Age-dependant defects in the innate and adaptive immune systems
The innate immune system normally provides fast and effective immune responses, but as we age this response slows resulting in an increase in disease. Susceptibility to disease is also reliant on a number of innate immune system barriers. This can include such things as the integrity of the skin, the flushing action of tears, saliva or urine and the action of ciliated epithelium and mucous. Dry, thinning skin can result in more injury and infection, and dehydration may result in further mucous membrane deterioration.
The adaptive immune system functions by - recognition to an antigen (a foreign substance or toxin which induces an immune system response), remembering the antigen and proliferation of cells which will provide antigen-specific immunity (antibodies). T lymphocytes are cell types which provide the highest potential of proliferation in the body and can survive for several decades – but they become damaged from wear-and-tear.
Strategies for improving immunity for the elderly
Nutritional deficiencies
Poor nutritional impacts an already impaired immune system. Three nutrients, zinc, vitamin E and vitamin D have been implicated in poor immunity of older people.
Zinc is an essential mineral which participates in many biochemical pathways and several cell functions, including the immune response. Levels of zinc are often low in older people and zinc deficiency is implicated in many diseases. A deficiency of zinc can also influence how the body responds to vaccination.
Vitamin E is not usually found to be deficient in people, but studies have shown increased intake of vitamin E enhanced immune function and reduced the incidence of upper respiratory infection in the elderly. Not only does vitamin E support immune function it is an antioxidant.
Antioxidants protect cells from the damaging effects of free radicals (which contribute towards the development of cardiovascular disease and cancer).
Antioxidants in Vitamin E help support the healing of skin wounds.
Many foods contain vitamin E. Wheat germ oil, safflower and sunflower oils, sunflower seeds, almonds and hazelnuts have good amounts. Supplements of vitamin E will have a bigger impact on health, but advice from health care provider advised due to potential medication interactions.
Vitamin D critical for bone health (along with calcium), but deficiency is also linked to infection. Older adults are at risk for lower levels of vitamin D due to decreased skin synthesis, deficient dietary intake of vitamin D and limited time outdoors. Evidence also indicates an association between low levels of vitamin D and diseases associated with aging such as cognitive decline, depression, osteoporosis, cardiovascular disease, hypertension, type 2 diabetes, and cancer.
The importance of nutrition
A decrease in appetite, inability to source foods and prepare healthy foods and poor dental health can mean a reduction in essential vitamins, minerals and fibre. It is important to make every meal and snack as nutritional as possible.
- A healthy diet consists of fruit and vegetables, proteins from meat, fish, poultry, dairy and legumes, fibre from nuts, seeds and wholegrains and healthy fats from fish, nuts, seeds and vegetables. Foods can be made into soups or dietary shakes for easier consumption.
- Foods with no nutritional value, or foods high in saturated or trans-fatty acids (pies, pastries, chips etc should only be consumed occasionally.
- Eat less salt. Salt is naturally found in many foods and can be added to many processed and packaged foods meaning more is ingested than is healthy. Too much salt contributes to high blood pressure and heart disease.
- Drink more water. Water is vital for many body functions but the sensation for thirst often decreases as we age.
A good quality multi-vitamin when appetite is poor, in nutritional deficiencies or illness may be necessary.
Other suggestions to support immune health
Black elderberry (Sambucus nigra) can directly inhibit the entry and replication of the influenza virus in human cells, can help strengthen the immune response and substantially reduce upper respiratory symptoms of cold and flu.
Stay active. Regular physical activity supports immunity, promotes circulation and reduces inflammation.
Prebiotics and probiotics have immunomodulatory effects and may enhance the efficacy of vaccines. The mechanisms of action include the prevention of bacterial growth (adhesion), modulation of the innate and adaptive immune systems and enhanced mucosal barrier function.
Curcuma longa (C. longa) commonly known as turmeric, offers anti-inflammatory, anticarcinogenic, anti-infectious, antioxidant and wound healing abilities, making it beneficial for many immune disorders.
Echinacea ( E. purpurea, E. angustifolia and E. pallida) is known as an immune stimulant of both innate and and specific immunity systems. It offers anti-inflammatory, anti-viral and anti-microbial activity and can be used as a therapeutic or as a prophylactic during times of potential immune threat (such as in winter). Echinacea may enhance the immune system after influenza immunization.
Manuka honey inhibits growth of many bacterial pathogens. It works with antibiotics, and can enhance their activity – preventing resistance, and renders resistant strains susceptible to destruction. Medical-grade manuka honey may clear topical infections and promote wound healing.
Please note - it is important to check with your health care provider before using supplements to avoid interactions with medication and health disorders.
Get vaccinated. Although the body may still have antibodies towards diseases, the ability of those antibodies to attach to antigens (foreign bodies) becomes less efficient as we age. This can result in infection of diseases previously protected from. The Influenza vaccine can reduce the risk of developing a flu virus especially for those with chronic lung disorders and heart disease. Check with your GP for other beneficial immunizations (tetanus for example).
Maintain a healthy weight
Avoid stress. Chronic stress decreases immunity and increases susceptibility to infections. Take time to enjoy the things you enjoy and don’t feel pressured to do more than you are capable of.
Sleep well. Poor quality and quantity of sleep can lower immunity.
Quit smoking!
References
- Immunosenescence: emerging challenges for an ageing population https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2265901/
- Aging of the Immune System. Mechanisms and Therapeutic Targets https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291468/
- https://www.msdmanuals.com/professional/immunology-allergic-disorders/biology-of-the-immune-system/overview-of-the-immune-system
- Probiotics in Disease Prevention and Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6656559/
- The global challenge and future strategies for keeping the world's aging population healthy by vaccination https://academic.oup.com/trstmh/article/110/8/427/2427510
- https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fflu%2Fabout%2Fqa%2Fvaccineeffect.htm
- Interventions to restore appropriate immune function in the elderly https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5785902/
- The compelling link between physical activity and the body's defense system https://www.sciencedirect.com/science/article/pii/S2095254618301005
- Zinc, aging, and immunosenescence: an overview https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321209/
- Vitamin E https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/
- The Role of Vitamin E in Immunity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266234/
- Nutritional modulation of age-related changes in the immune system and risk of infection https://www.sciencedirect.com/science/article/pii/S0271531716305024?via%3Dihub
- The Role of Vitamin D in the Aging Adult https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399494/
- https://www.nutritionaustralia.org/national/resource/nutrition-and-older-adults
- Therapeutic Manuka Honey: No Longer So Alternative https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837971/
- Immunomodulators Inspired by Nature: A Review on Curcumin and Echinacea https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6278270/
- Use of a standardized extract from Echinacea angustifolia (Polinacea) for the prevention of respiratory tract infections. https://www.ncbi.nlm.nih.gov/pubmed/22502621
- Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. https://www.ncbi.nlm.nih.gov/pubmed/30670267
- Elderberry compounds could help minimize flu symptoms, study suggests https://www.sciencedaily.com/releases/2019/04/190423133644.htm
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