The most common immune disorders in seniors primarily involve autoimmune diseases, inflammatory conditions, and immune system decline that leads to increased susceptibility to infections and chronic inflammation. As people age, their immune systems undergo changes that can both reduce their ability to fight infections and increase the risk of immune system malfunctions, such as autoimmune disorders.
One of the most frequent immune-related disorders in older adults is **giant cell arteritis (GCA)**. This is an autoimmune vasculitis that targets medium and large arteries, especially those in the head, such as the temporal arteries. It causes inflammation that narrows blood vessels, reducing blood flow and potentially damaging the vessel walls. GCA is particularly common in people over 50, with incidence peaking in the 70s and 80s, and it affects women more often than men. Symptoms include new headaches, jaw pain, and sudden visual changes. If untreated, it can lead to serious complications like permanent vision loss or aortic aneurysms. Treatment typically involves fast-acting steroids to prevent vision loss, but managing the disease long-term remains challenging. Interestingly, research has found specialized “stem-like” T cells in inflamed arteries of older patients, which behave like youthful immune cells but contribute to the autoimmune process in GCA.
Another group of immune disorders common in seniors are **autoimmune blistering skin diseases**, such as **pemphigus vulgaris**, **bullous pemphigoid**, **cicatricial pemphigoid**, and **linear IgA bullous disease**. These conditions cause blistering of the skin and mucous membranes and tend to have a higher incidence in older adults, often starting around age 50 to 60. For example, pemphigus vulgaris is a systemic autoimmune disease that can be life-threatening if not promptly diagnosed and treated. Bullous pemphigoid is more common in the elderly and involves large, tense blisters on the skin. These skin disorders reflect the immune system mistakenly attacking components of the skin, leading to inflammation and blister formation.
**Dermatomyositis**, another autoimmune disorder, is also more frequently diagnosed in older adults and can sometimes signal an underlying malignancy. It causes muscle weakness and characteristic skin rashes. Because it can be associated with cancer, its diagnosis in seniors often prompts thorough cancer screening.
In addition to autoimmune diseases, seniors face increased risks from **immune senescence**, the gradual decline of immune function with age. This decline leads to a reduced ability to respond to infections and vaccines, making older adults more vulnerable to respiratory viruses such as **respiratory syncytial virus (RSV)**. RSV can cause mild cold-like symptoms in healthy individuals but may lead to severe lower respiratory tract infections, pneumonia, and exacerbation of chronic conditions like asthma, congestive heart failure, and chronic obstructive pulmonary disease (COPD) in seniors. Because immunity wanes with age, vaccines against RSV and other infections are particularly important for older adults.
Interestingly, some autoimmune diseases like **lupus** may show a decrease in symptom severity with age. Research indicates that immune overactivity, which drives lupus symptoms, tends to diminish in older patients, leading to a natural reduction in inflammation. This phenomenon suggests that aging can sometimes modulate autoimmune activity, although this is not the case for all immune disorders.
Chronic inflammation, often called “inflammaging,” is another hallmark of aging immune systems. Persistent low-level inflammation can contribute to various age-related diseases and complicate immune disorders. Conditions such as **stasis bullae** and **coma bullae**—types of skin lesions—can develop in elderly patients due to chronic edema, immobility, or prolonged unconsciousness, reflecting the interplay between immune dysfunction and other health issues common in seniors.
In summary, the most common immune disorders in seniors include autoimmune vasculitis like giant cell arteritis, autoimmune blistering skin diseases such as pe
