Challenges of infectious diseases in older adults: From immunosenescence and inflammaging through antibiotic resistance to management strategies

IF 5.3 3区医学 Q2 CELL BIOLOGY

Mechanisms of Ageing and Development Pub Date : 2024-10-22 DOI:10.1016/j.mad.2024.111998

Francesca Mancinetti , Anna Marinelli , Virginia Boccardi , Patrizia Mecocci

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引用次数: 0

Abstract

Infectious diseases in older adults present a significant challenge to the healthcare system, marked by increased morbidity, mortality, and rising costs of care. Age-related changes (ARCs) in the immune system, including immunosenescence and inflammaging, contribute to heightened susceptibility to severe infections and reduced vaccine responsiveness. Additionally, alterations in the normal microbial flora due to aging and factors such as antibiotic therapy predispose older individuals to infections and age-related diseases. Changes in body composition also affect the pharmacokinetics and pharmacodynamics of drugs, complicating the management of antibiotics and leading to potential overdoses, adverse drug reactions, or underdoses that foster antibiotic resistance. The inappropriate use of antibiotics has exacerbated the emergence of multidrug-resistant pathogens, posing a critical global concern. This narrative review provides an overview of immunosenescence and inflammaging and focuses on three major infectious diseases affecting older adults: bacterial pneumonia, urinary tract infections, and Clostridium difficile infections. Through this exploration, we aim to highlight the need for targeted approaches in managing infectious diseases in the aging population.

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老年人传染病的挑战：从免疫衰老和炎症到抗生素耐药性，再到管理策略。

老年人的传染病给医疗保健系统带来了巨大的挑战，其特点是发病率、死亡率和护理成本上升。免疫系统中与年龄相关的变化（ARCs），包括免疫衰老和炎症老化，导致对严重感染的易感性增加和疫苗反应性降低。此外，由于衰老和抗生素治疗等因素导致的正常微生物菌群的改变，也容易使老年人感染和患上与年龄相关的疾病。身体成分的变化也会影响药物的药代动力学和药效学，使抗生素的管理复杂化，导致潜在的用药过量、药物不良反应或用药不足，从而产生抗生素耐药性。抗生素的不当使用加剧了耐多药病原体的出现，引发了严重的全球性问题。这篇叙述性综述概述了免疫衰老和炎症，并重点关注影响老年人的三种主要传染病：细菌性肺炎、尿路感染和艰难梭菌感染。通过这一探讨，我们旨在强调有必要采取有针对性的方法来管理老龄人口中的传染病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Mechanisms of Ageing and Development 医学-老年医学

CiteScore

11.10

自引率

1.90%

发文量

审稿时长

32 days

期刊介绍： Mechanisms of Ageing and Development is a multidisciplinary journal aimed at revealing the molecular, biochemical and biological mechanisms that underlie the processes of aging and development in various species as well as of age-associated diseases. Emphasis is placed on investigations that delineate the contribution of macromolecular damage and cytotoxicity, genetic programs, epigenetics and genetic instability, mitochondrial function, alterations of metabolism and innovative anti-aging approaches. For all of the mentioned studies it is necessary to address the underlying mechanisms. Mechanisms of Ageing and Development publishes original research, review and mini-review articles. The journal also publishes Special Issues that focus on emerging research areas. Special issues may include all types of articles following peered review. Proposals should be sent directly to the Editor-in-Chief.