What we can do to help them boost their immunity?

1. Set up a balanced diet plan for them

Good health go hand in hand. In fact, to boost the elderly’s immune systems, a good diet of foods rich in certain vitamins and minerals can help defend against infection and illness. This includes eating a diet rich in fruits and vegetables, which contain vitamins and antioxidants (Such as Vitamin C, D, Zinc, Selenium, Iron & Protein) to promote good health.

2. Spend some time to talk to them

While they get older, our loved seniors may have experienced mental health-related issues like alzheimers and dementia, especially because they focus on how their age is increasing and they are not as strong as they used to be. If left unaddressed, it can invite serious social and health complications like anger, fatigue, weight loss, etc. Help your aging loved one to develop a healthy by trying our best to spend some time talking to them every day and understand their needs.

3. Ensure their get active

You have seen elders locking themselves in their room believing that they should be resting all the time. The problem with it is that their lives become less interesting and they get more stressed. Try to invite them out for outdoor activities or exercising together and then will make them embrace their retired life more.

4. Schedule for regular medical check-up

Never miss a visit to the medical facility for regular health screening test even if your elderly loved one don’t have any illness. Doing this will not only maintain their well-being but also provide them the confidence to live.

5. Plan for their supplements

When thinking of how to boost the immune system in the elderly, we may immediately reach for vitamin supplements. You may consider Vitamin C and D that contained the biggest benefits to the immune system for seniors.

Think of the elderly immune system not as a single body process, but rather a network of systems working together to promote well-being.

Source from: Copyright © 2011, Harvard University. For more information about The Healthy Eating Plate, please see The Nutrition Source, Department of Nutrition, Harvard T.H. Chan School of Public Health, www.thenutritionsource.org, and Harvard Health Publications, www.health.harvard.edu.

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Respiratory infections are a leading cause of morbidity and mortality in the elderly. It can be due to viruses, bacteria or fungi. Symptoms are usually a combination of lung-related symptoms such as difficulty breathing, chest discomfort and coughing (with or without phlegm), alongside more general symptoms like lethargy, fever and weight loss.

In Malaysia, a local study has indicated that those above the age of 65 infected with influenza-like illnesses are at a 10% greater risk of mortality. ⁽¹⁾

Unfortunately, many people still do not realize how vital respiratory health is when it comes to aging well. In fact, keeping your respiratory system healthy can improve your quality of life and help you live longer.

Aging is associated with multiple structural changes in the respiratory system, resulting in increased susceptibility to disease processes. As we age, factors such as impaired immunity and malnutrition tend to increase the risk of respiratory infection.

Immune System in Elderly

Immune function naturally decreases with age, which makes seniors more susceptible to respiratory illnesses. As we grow older, our immune system does not work as well and becomes slow to respond. Therefore, older adults have a far higher risk of contracting infections and severe complications than younger people.

The Elderly are more likely to get sick.  As people age, not only do they have fewer immune cells but the ones they have do not communicate well with each other. It means the immune cells take longer to react to harmful bacterial. As a result, elderly individuals do not respond to the immune challenges as robustly as the young and they also tend to recover from infections and illnesses more slowly.

Apart from that, the immune system of the elderly will be even weaker when an older adult is also living with a chronic condition such as diabetes, high blood pressure, heart disease and cancer. People with underlying chronic conditions are often in active inflammatory states, which may compromise the efficacy of their immune systems.

Ways to Improve Immunity and Respiratory Health

Ø Eat well-balanced meals

A healthy diet is essential to a strong immune system. Older adults sometimes have issues with immunity because of a lack of sufficient nutrition. Difficulty chewing, swallowing or poor dental health can contribute to malnutrition. Not getting enough essential vitamins and minerals can make the immune system work harder.

• A well-balanced diet includes a variety of fruits, vegetables, whole grains, a variety of protein foods, fat-free/low-fat dairy and healthy fats.
• Use more healthy cooking methods such as steaming, boiling, poaching, stewing, baking or stir-frying.
• For the easy chewing purposes, try to chop vegetables into smaller sizes, cook meat until soft, blend the soup into pureed or soak wholegrain bread into milk.
• Try to include some key immune-boosting supplementation if the elderly is really unable to get it through diets such as Protein, Vitamin C, Vitamin D and Zinc.

Ø Exercise and stay active

Exercise is one of the most important ways to keep the respiratory system healthy. Regular exercise can help the immune system function at optimal levels to fight off viruses and infection, increases blood circulation and also make the muscles, heart and lungs stronger. Current research stated that physical exercise is seen as the main ally for health promotion, preventing and protecting the elderly from several diseases infections. ⁽²⁾

Aim for at least 30 minutes of physical activity a day. Brisk walking, tai chi, yoga, deep breathing exercise and cycling are just some of the many ways older adults can get sufficient exercise. It is important to encourage your aging loved ones to find enjoyable activities that match their fitness level.

Ø Spend time outdoors

Vitamin D, known as the “Sunshine Vitamin “, helps to strengthen the immune system. Spending additional time outdoors allows the body to naturally convert vitamin D from sun exposure and improve overall immunity. Research suggested that Vitamin D has a potential role in the prevention of respiratory tract infections by increasing immunity. ⁽³⁾   

By spending just 15 minutes outside in the sunshine each day, will help their body receive the dose of Vitamin D. Gardening is one of the most popular outdoor activities for elderly. Remember to head outside when the sun is not too strong to avoid a sunburn.

Ø Stay hydrated

Dehydration is a very common problem in the elderly and often leads to many health issues. Dehydration can cause mucus to thicken and get sticky, which slows down the overall respiratory and make the elderly more susceptible to illness and other respiratory problems. A study suggested that dehydration resulted in immunosuppression, including decreased neutrophil (an important type of tissue-healing and infection-fighting white blood cell) function. ⁽⁴⁾

Adequate hydration is a key immune booster for the elderly. Water helps their body absorb nutrients and minerals, and flush body waste.  Drinking at least eight glasses of fluid a day can help them avoid dehydration. Some tips to help your aging loved one stay hydrated:

• Drink a glass of water before and after every meal and in-between snacks.
• Try Keeping a water bottle/cup near their favorite seat for sipping throughout the day.
• Try to offer some smoothies, milkshakes or soup.
• Try adding some fruits like berries, lemons, limes, cucumbers and mint to water for flavor.

Ø Get plenty of sleep

Insufficient sleep not only reduces the effectiveness of the immune system to respond to infection and inflammation, but it also linked to many chronic diseases such as diabetes, heart disease, obesity and depression. As we age, we often experience changes in our sleeping patterns, such as becoming sleepy earlier, waking up earlier, experiencing less deep sleep or even having insomnia. A study showed that short sleep duration (5 hours or less) and sleep disturbances (insomnia) increased susceptibility to upper respiratory tract infection. ⁽⁵⁾

For the elderly, try to aim for at least seven to eight hours of sleep each night on a regular schedule. Some ways to improve the quality of sleep among the elderly include:

• Keep a consistent bedtime routine.
• Limit daytime naps to no more than 45 minutes.
• Do some gentle stretches to relieve built-up tension before bedtime.
• Making the bedroom a comfortable sleep environment.

In a nutshell, the immune system becomes less effective in the elderly compared to younger people. The changes in immune function may contribute to the greater susceptibility of older people to some infections and may lead to more serious disease complications. Thus, it is important to take steps to strengthen the immune system in the elderly to reduce the risk of any respiratory diseases.

References:

1. Pui Li Wong et al. The effects of age on clinical characteristics, hospitalization and mortality of patients with influenza-related illness at a tertiary care centre in Malaysia. Influenza Other Respir Viruses. 2020 May;14(3):286-293.

2. Fabiana et al. Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period. Front Psychol. 2020; 11: 593903

3. Jaykaran charan et al. Vitamin D for prevention of respiratory tract infections: A systematic review and meta-analysis. J Pharmacol Pharmacother. 2012 Oct-Dec; 3(4): 300–303.

4. Takeharu Chishakiet al. Effects of dehydration on immune functions. Luminescence. Mar-Apr 2013;28(2):114-20.

5. Aric A Pratheret al. Association of Insufficient Sleep With Respiratory Infection Among Adults in the United States. JAMA Intern Med. 2016 Jun 1;176(6):850-2.

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Vitamin D is vital to the health and well-being of older adults. Despite the universal need for Vitamin D, older populations worldwide experience Vitamin D deficiency in high numbers. In other words, as individuals age, the risk of vitamin D deficiency increases.

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This might be due to older adults tend to spend the majority of their time indoors and get minimal exposure to natural sunlight. Moreover, as the skin thins with age, Vitamin D synthesis becomes much less efficient. Reduced appetite and impaired absorption of nutrients further compound this problem for seniors.

Benefits of Vitamin D for Elderly

• Bone health

Vitamin D is important for strong bones and muscles. It helps to prevent the bone disease osteoporosis, a condition that causes bones to become brittle and weak. Without Vitamin D, our bodies cannot effectively absorb calcium, which is essential to good bone health. Low Vitamin D levels contribute to an increased risk for falls, fractures, poor physical balance and muscular weakness.

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A 2019 American Medical Association analysis of 49,000 found seniors who combined adequate vitamin D levels and sufficient calcium intake reduced their risk of hip fractures by 16%. ⁽¹⁾ Another study showed hip fractures are reduced by 20% in elderly who take 400 IU of Vitamin D supplements daily.⁽²⁾

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• Immune health

Immune functions naturally deteriorate as people age. Thus, the elderly tend to have weakened immunity. Vitamin D can help to boost seniors’ immune systems to fight against illnesses like flu, colds and other respiratory conditions.

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A 2017 meta-analysis of data from 25 randomized clinical trials reported that vitamin D promotes “natural antibiotic-like substances” in the lungs and protect against acute respiratory infections like colds and flu. ⁽³⁾

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• To boosts elderly happiness and mental health

Low levels of Vitamin D may contribute to poorly regulated mood and behavior, impair cognitive function, poor brain health and depression. Vitamin D is believed to help regulate the release of neurotransmitters (dopamine, serotonin) in the brain that influence moods/ happiness.  Seniors who feel depressed and tired all the time may actually suffer from vitamin D insufficiency or deficiency.

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A 2017 study of more than 5,600 older adults found a link between lower levels of vitamin D and depressive symptoms, such as loneliness, lack of enjoyment, and restless sleep. ⁽⁴⁾  Meanwhile, a finding from a clinical trial data indicated that Vitamin D supplementation  can improve the depression score in persons aged 60 and over. ⁽⁵⁾  

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The recommended nutrient intakes (RNI) for vitamin D for Malaysian aged 1 to 70 years is 600 IU per day and  800 IU a day for adults older than 70. ⁽⁶⁾ Some ways to get the recommended dose of vitamin D for elderly are:

• Take a morning walk and get approximately 5 to 10minutes of sun exposure twice a week since sunshine is one of the best natural sources of vitamin D.
• Consume vitamin Drich food sources such as tuna, sardines, mackerel, salmon,  mushrooms and eggs.
• Taking health supplement products with an adequate amount of vitamin D might be needed by elderly in maintaining an optimal Vitamin D level.

In conclusion, Vitamin D is important in creating a healthy immune system and strong bones. Vitamin D deficiency in elderly may trigger severe health problems like osteoporosis, increases risks of fractures/ falls, fatigue, pain and depression. Therefore, it is important to ensure that elders obtain enough vitamin D to stay healthy.

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References:

1. Yao P, Bennett D, Mafham M, et al. Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019;2(12):e1917789. doi:10.1001/jamanetworkopen.2019.17789

2. Heike A Bischoff-Ferrari, et al. Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Arch Intern Med. 2009 Mar 23;169(6):551-61.

3. Adrian R Martineau, et al. Vitamin D supplementation to prevent acute respiratory tract infections:

systematic review and meta-analysis of individual participant data. BMJ 2017;356:i6583

4. Cesar de Oliveiraet al. Associations Between Vitamin D Levels and Depressive Symptoms in Later

Life: Evidence From the English Longitudinal Study of Ageing (ELSA). The Journals of Gerontology: Series A, Volume 73, Issue 10, October 2018, Pages 1377–1382

5. Negin et al. Effect of vitamin D supplementation on depression in elderly patients: A randomized

clinical trial. Clin Nutr. 2019 Oct;38(5):2065-2070

6. Recommended Nutrient Intakes Malaysia 2017

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