ALLERGY IN THE AGED

Abstract

Diseases due to allergy are less frequent in old age, but can occur then, since easy sensitizability is an inborn life-long characteristic of the allergic person. Particular sensitivities tend to be self-limited, so that the allergic pattern changes with the years. Acute manifestations (hay fever, urticaria and migraine) are less common. Of chief moment are skin allergies (pruritus, eczema, contact dermatitis from cosmetics and ointments), drug reactions (laxatives, antibiotics, especially penicillin) and respiratory allergy (rhinitis, asthma). Infection usually complicates asthma in the aged, but one must not overlook the allergic factor that is usually also present. It is a mistake to assume that allergy in the aged is necessarily "intrinsic." Diagnosis is more difficult because skin reactivity is less marked in old age, and therefore skin tests are less helpful. More dependence must be placed on history and on diary of symptoms and exposures. Treatment is directed against the allergic factor (avoidance; hyposensitization against the unavoidable) and against infection (attention to foci; autogenous vaccines; climatic therapy). ACTH and Cortisone are useful to stop an allergic reaction, but should not be used except in an emergency, or unless the cause of the reaction be known (e. g., in penicillin allergy), since they do not alter the underlying sensitivity.