Older adults are particularly susceptible to several common fungal infections due to factors like weakened immune systems, slower nail growth, reduced circulation, and chronic health conditions such as diabetes. The most frequent fungal infections in this population include nail infections (onychomycosis), yeast infections (cutaneous candidiasis), oral candidiasis, and certain systemic fungal infections like Valley fever.
**Onychomycosis (Nail Fungal Infection)** is one of the most prevalent fungal infections among older adults. It affects the fingernails or toenails, causing discoloration, thickening, brittleness, and sometimes separation of the nail from the nail bed. This infection is mainly caused by dermatophytes but can also be due to yeasts or molds. Older adults are more prone to onychomycosis because their nails grow more slowly and circulation to the extremities is often reduced. Nail trauma or prolonged exposure to moist environments, such as sweaty shoes, can trigger the infection. Onychomycosis can be more than a cosmetic issue; in elderly individuals, especially those with diabetes or weakened immune systems, it can lead to complications like secondary bacterial infections or cellulitis. Treatment requires careful diagnosis and often involves oral antifungal medications, though topical treatments may be used in milder cases or when systemic drugs pose risks due to side effects or interactions with other medications.
**Cutaneous Candidiasis (Yeast Infection of the Skin)** occurs when Candida yeast, which normally lives harmlessly on the skin and mucous membranes, overgrows in warm, moist areas of the body. Older adults with diabetes, obesity, or compromised immune systems are particularly vulnerable. Factors such as prolonged antibiotic use, pregnancy, and wearing tight or non-breathable clothing can increase susceptibility. This infection commonly affects skin folds, such as under the breasts, groin, and between toes, causing redness, itching, and sometimes a rash with satellite lesions. Managing cutaneous candidiasis involves keeping affected areas dry and clean, using antifungal creams or powders, and addressing underlying risk factors.
**Oral Candidiasis (Thrush)** is another fungal infection disproportionately affecting older adults, especially those with weakened immunity or undergoing treatments like chemotherapy. It manifests as white patches or plaques on the tongue, inner cheeks, roof of the mouth, or throat, often accompanied by soreness or difficulty swallowing. Oral candidiasis can impair nutrition and quality of life in elderly patients. Treatment typically involves antifungal mouthwashes or lozenges, along with good oral hygiene.
**Valley Fever (Coccidioidomycosis)** is a systemic fungal infection caused by inhaling spores of the *Coccidioides* fungus, which lives in soil in certain geographic regions such as California’s Central Valley and parts of the southwestern United States. Older adults, especially those over 60, people with diabetes, and certain ethnic groups like Black and Filipino individuals, are at higher risk of developing severe forms of this infection. While many cases cause mild respiratory symptoms or go unnoticed, disseminated Valley fever can spread to bones, joints, skin, and even the brain, leading to serious complications. It is not contagious from person to person but is acquired from environmental exposure, particularly in outdoor activities involving soil disturbance.
Another emerging concern in older adults, particularly those in healthcare settings, is infection with *Candidozyma auris* (formerly *Candida auris*), a yeast species that can cause invasive candidiasis. This fungus is notable for its resistance to multiple antifungal drugs and its ability to cause bloodstream infections, which can be life-threatening. It often affects patients with weakened immune systems, including elderly hospitalized individuals. Identification and treatment are challenging due to its drug resistance and similarity to other Candida species.
In addition to these, older adults may also experience other fungal infections such as athlete’s foot, jock itch, and scal