Age-dependent differences in anaphylaxis: Elderly population

Purpose of reviewAnaphylaxis in elderly is a little-known topic, despite the worldwide growth of this part of the population. In this review, the main elicitors are discussed, with a particular regard for risk factors, clinical manifestation and management of anaphylaxis in people over 65 years of age.Recent findingsAvailable data report age-dependent differences regarding elicitors, cofactors and symptoms of anaphylaxis. In the last years, few studies have focused on anaphylaxis in the elderly, highlighting drugs and insect venom as main triggers.SummaryDrugs and insect venom represent the main triggers of anaphylaxis in individuals over 65 years of age. In addition, idiopathic anaphylaxis is seen more frequently in adults and older adults, and recent studies show an increasing rate of food-related anaphylaxis in this population.Elderly patients are at a greater risk of severe or fatal reactions because they often have multiple comorbidities requiring the concomitant use of several drugs. This may complicate anaphylaxis management, leading to poor outcomes, increased hospitalization and higher admission to intensive care unit.The clinical presentation of anaphylaxis in older adults is most often characterized by cardiovascular symptoms, with syncope as the most frequent one.The injection of adrenaline is the most important treatment of anaphylaxis at any age, and no absolute contraindications are reported. Despite this, its use still remains suboptimal.