Whitepaper: Nutritional Care to Support Immune Health in the Elderly

• Building a strong immune system has never been more relevant – especially in older people who do not respond to immune challenges, like infection and disease, or vaccinations as robustly as younger generations.
• We get an expert perspective on immunity in the elderly from Barbara Troesch, Senior Scientific Affairs Manager Global Medical Nutrition & Pharmaceutics, dsm-firmenich, including why our immune systems become weaker as we age and how immunity can be optimized through the development of specialized nutrition solutions.
• Read on for access to our NEW whitepaper and discover how you can support the quality of life and independence of older adults.

Why are older individuals more vulnerable to infection?

Known as immunosenescence, immune function gradually declines as we age. This impacts our capacity to respond to infection and maintain long-term immune memory, which in turn increases our vulnerability towards disease and infection. Inflammaging – or chronic low-grade inflammation – is also common with advancing age. Inflammation is an important component of the immune response, but sustained inflammation can accelerate biological aging and contribute to many age-related (often co-existing) conditions, including cardiovascular disease, cancer, frailty, sarcopenia and Alzheimer’s disease. These conditions, in turn, can further impact an already weakened immune system.

In addition, malnutrition, which is more common and often overlooked in older people, is strongly associated with a reduction in immune function. This is because an adequate and balanced nutritional status is essential for an effective immune response, especially during times of infection, as certain nutrients help immune cells to function properly and resolve inflammation.

Why is malnutrition an issue in older people specifically?

Malnutrition is estimated to affect between 15-30% of older people globally, and about 60% of care home residents are at risk.¹ There are a number of factors contributing to malnutrition in the senior population, including ‘anorexia of aging’ and medication use.

“Anorexia of aging is a complex and multifactorial condition associated with loss of appetite and/or decreased food intake,” explains Barbara Troesch. “It can be the result of alterations in digestive function, hormonal fluctuations, disease, pain and changes in smell, taste and vision, which strongly influence appetite. Because of anorexia of aging, older individuals are less likely to obtain the nutrients and energy they need to maintain optimal immune function.”

How does this impact the response of older people to vaccinations?

The COVID-19 vaccine program was rolled out at a rapid speed across the world. However, despite responses to the vaccine being higher than those observed in flu vaccines, older people – especially those that are frail or malnourished – are still at risk of poorer responses compared to younger people, and also a shorter duration of protection.² What’s more, the emergence of new variants with increased transmissibility and reduced sensitivity to vaccine-elicited antibodies bring further challenges in vulnerable groups like the elderly.³

Troesch explains: “The same mechanisms that generate an effective immune response to infection also help to generate immunity to vaccination. It is therefore believed that micronutrient deficiency contributes to poor vaccine response. For this reason, it’s important to support older individuals with nutrients and minerals linked to strong immune health, like vitamin C and D, as well as zinc, copper, iron and selenium.”

Supplementation is a safe, inexpensive and effective way to help provide a foundation for a healthy immune response. A supplement containing nutrients that are well-known to support immune function, taken in the weeks leading up to vaccinations, may therefore help to overcome poor vaccine responses in older populations.

Is there a role for specialized nutrition?

A food-first approach is always recommended – that is encouraging individuals to eat healthy, balanced meals. But if that is not possible and an older person is at high risk of malnutrition, expert guidelines recommend the use of specialized nutrition products – like oral nutritional supplements, enteral feeding (tube feeding) or parenteral nutrition – to support health and immunity.

“It’s important to make specialized nutrition solutions nutrient dense to help overcome issues such as filling up too quickly on oral nutritional supplements, and then not eating at normal mealtimes; further decreasing quality of life,” Troesch comments. “Moreover, it is crucial that solutions are as appealing as possible to older people to improve compliance. This involves offering a range of formats, flavors and textures, and developing products that can be easily integrated into mealtimes.”