In the elderly, the prevalence of food allergies is estimated at 5% to 10%,1,2 but is likely underestimated and underdiagnosed, and thus undertreated. A study reported that 24.8% of geriatric nursing home patients (mean age of 77) were positive (skin test) for food allergens.3,4 It is speculated that 25% to 30% of adults self-diagnose food allergies, but the true prevalence is approximately 5% in industrialized countries.4,5 Notably, food allergies can develop at any time and are not limited to manifestation in the pediatric population. In the elderly, confounding factors include decreased stomach acid (leading to decreased protein digestion and increased in vivo exposure to absorbed allergenic epitopes) and an age-related decrease in total serum immunoglobulin E (IgE).
Seasonal and chronic conditions affect seniors a little differently than it does the rest of the population. Medical professionals have to take age, and mental and physical conditions into consideration when diagnosing these patients, as the regular course of care may not be the best plan of action.
Once a food allergy has been diagnosed, the only approved method for effective management is avoiding the allergen. It is important to note that once a food allergen is totally eliminated from the diet, reactions can become more obvious and will usually increase in severity. As to avoidance, some foods are easier to eliminate than others. Food labels containing ingredient lists are essential tools for prepackaged foods. However, when older adults dine out or visit well-intentioned friends and family, avoidance becomes a bit more challenging.
Lack of knowledge and cross-contamination of foods can lead to a reaction. Caution is necessary and may require an individual to ask various questions. Requesting to see an ingredient list from a package or in a recipe may be crucial. If the establishment or the individual is unable to answer questions or produce the requested food label, then it is best to avoid the unknown unless the individual is prepared to deal with a reaction.
The loved ones of seniors battling these issues can take these four steps to ensure the effects allergies have are minimal:
1. Focus on providing clean air: Having the windows open can wreak havoc on the allergies of seniors. Turn on the AC during the warmer months and invest in a dehumidifier that captures pesky particles from circulating.
2. Ask for an allergy test: There are two types of assessments healthcare providers may use – a prick (allergen pricked/scratched into the skin) or an intradermal test (injected under the skin). With this information, medical professionals can understand whether the issue is seasonal or chronic.
3. Maintain good hygiene: Be sure your family members are not only bathing frequently, but also cleansing themselves after spending time outdoors. Clothes should be washed and dried inside as opposed to on a clothing line so as to avoid the more wind-borne allergens from becoming trapped.
4. Eat the right foods: Did you know that eating certain foods could decrease some allergy symptoms? According to Medical Alert Advice, apples, leafy greens, walnuts and items high in Vitamin C can reduce inflammation. Read all food labels and recheck periodically, as ingredients will change. It’s important to avoid if uncertain. Modify recipes. Many websites provide appropriate substitutions and/or modified recipes. Check out a restaurant’s menu before arrival. If several menu items contain the food allergen, cross-contamination is highly probable. Bring safe food to a function, outing, cookout, or holiday dinner. If shared, discard any leftovers, as cross-contamination is likely. Eat a snack or meal prior to attending.
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