The author studied nutritional strategies in treated older adults to reduce their increased risk of immune dysfunction, with a goal of reducing the risk of infections. Immune senescence is the natural decline of immunity with aging and nutritional strategies have been of benefit in relieving immune senescence.
Up to 65% of hospitalized elderly patients are malnourished, which results in low body weight, muscle wasting, thinning hair, dermatitis, poor wound healing and edema of the feet and hands. Up to 85% of elderly people with community-acquired pneumonia are malnourished. There is evidence that in a malnourished host a virus may undergo mutations, resulting in increased virulence of the virus and more severe disease in the host. Possible causes of malnutrition in the elderly are depression, dental disorders and anorexia due to medications.
There is some evidence that trace mineral supplementation may be more important than multivitamin supplementation in preventing infections. Zinc has been shown to reduce infections and improves healing in venous stasis ulcers. Cranberry juice helps reduce urinary tract infections and reduces the amount of antibiotic use.
CONCLUSION: The authors suggest the use of a multi-vitamin and multi-mineral supplementation with zinc (over 20 mg/day,) selenium (100 mcg./day,) and Vitamin E (200 I.U./day.) Specific supplements, such as cranberry juice, reduce urinary tract infections and antibiotic use. The immune-depressed elderly may be malnourished and this should be evaluated.