A cold or the flu can be especially risky for people over age 65 because they are more likely than younger adults to develop life-threatening complications. Colds and the flu are contagious viral illnesses that spread primarily through the release of viral particles when an infected person coughs or sneezes. The illnesses can also be contracted by touching a virus-contaminated object and then transferring the germs to your eyes, nose or mouth. It's important to prevent viral infections in the elderly because treatment options are limited. Hospitalization may be necessary if complications occur.
The flu, or influenza, is a significant health threat to the elderly. Between 1976 and 2007, nearly 90 percent of the deaths from influenza occurred in people 65 or older, according to the National Foundation for Infectious Diseases. The best way to prevent the flu is to be vaccinated every year, recommends the Centers for Disease Control and Prevention.
People age 65 or older may take either the regular flu vaccine (Fluzone, Afluria, FluLaval, Fluarix, Fluvirin, Agriflu, Flucelvax) or a higher dose version (Fluzone High-Dose). Both types are made from three strains of influenza viruses that have been killed, or inactivated. Flu shots for seniors are administered by injection into a muscle. The regular flu vaccine is suitable for anyone over the age of 6 months. A higher dose vaccine was made available beginning with the 2010-2011 flu season to stimulate a better immune response in older adults. Studies have confirmed an improved immune response in the elderly with the high-dose flu vaccine. It is unclear, however, whether the augmented immune response translates into better protection against the flu.
Even people who have been vaccinated need additional protection from getting the flu or a cold. It takes about 2 weeks to develop immunity to the flu after vaccination, and there is no vaccine to protect against the common cold.
Preventive measures should include using a paper towel or tissue when turning doorknobs in public places; wiping down telephone receivers; and washing hands frequently. Because infected people can spread cold and flu viruses before they have symptoms, elderly people should consider avoiding crowded places where the risk of exposure is high.
Those who live in households with children should be especially cautious because youngsters are less likely than adults to cover their mouths when coughing or sneezing. Frail older people may want to wear a protective mask when coming into contact with infected or potentially infected visitors and family members.
Elderly caregivers may not be protected by the flu vaccine as well as younger caregivers, according to virologist Nicole Powell, Ph.D. After reviewing clinical and animal studies on the effects of stress and other factors on immune responses, Powell concluded that adults who are severely and chronically stressed -- such as those caring for a mate with a serious, long-term illness -- have a decreased antibody response to vaccination.
While advanced age may be a factor in decreased immunity, other possible causes for the reduced response to flu vaccines may include loneliness, depression, stress, isolation and lack of social support often experienced by elderly caregivers. To boost their immune responses, elders in caregiving situations might consider exercising and taking appropriate measures to increase emotional support and reduce stress.
Two types of antiviral medications are available to treat the flu in elderly people who were not vaccinated or were not sufficiently protected by the vaccine. These medications must be administered within the first 48 hours after symptoms appear, so elderly people and their caregivers should be on alert for flu symptoms and seek medical attention quickly.
Older people in long-term care and assisted living facilities are at increased risk for contracting the flu. Therefore, they are sometimes medicated for 6 weeks with oral oseltamivir (Tamiflu) as a protective measure in addition to flu vaccination.
- Centers for Disease Control and Prevention: Prevention and Control of Influenza With Vaccines
- Centers for Disease Control and Prevention: Seasonal Influenza (Flu): Infection Control in Health Care Facilities
- Immunology and Allergy Clinics of North America: Stressor-Induced Alterations of Adaptive Immunity to Vaccination and Viral Pathogens
- Journal of the American Geriatrics Society: Long-Term Use of Oseltamivir for the Prophylaxis of Influenza in a Vaccinated Frail Older Population
- Centers for Disease Control and Prevention: Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities
- Centers for Disease Control and Prevention: Fluzone High-Dose Seasonal Influenza Vaccine
- Clinical Infectious Diseases: Current Strategies for Management of Influenza in the Elderly Population
- National Foundation for Infectious Diseases: Understanding the Challenges and Opportunities in Protecting Older Adults From Influenza
- Clinical Geriatrics: Update on Prevention and Treatment of Influenza in the Elderly