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Anergy testing in nursing home residents
J C Delafuente1, J R Meuleman, R C Nelson
1Department of Pharmacy Practice, Colleges of Pharmacy, University of Florida, Gainesville.
Journal of the American Geriatrics Society
|August 1, 1988
Summary
Delayed cutaneous hypersensitivity (DCH) testing in elderly individuals with chronic diseases revealed preserved cellular immunity. The Multitest CMI device effectively assessed DCH, showing low anergy rates in this population.
Area of Science:
- Immunology
- Gerontology
Background:
- Delayed cutaneous hypersensitivity (DCH) testing assesses cellular-mediated immunity and Mycobacterium tuberculosis exposure.
- Anergy is often reported in the elderly, but recent studies suggest this may be mitigated by using multiple antigens.
- Practical challenges exist in applying numerous individual DCH antigens.
Purpose of the Study:
- To evaluate the effectiveness of the Multitest CMI device for DCH testing in geriatric patients with chronic diseases.
- To assess the prevalence of anergy in elderly nursing home residents.
Main Methods:
- The Multitest CMI, applying seven antigens and a control, was used on 29 nursing home residents.
- Ten young healthy subjects served as controls.
- DCH reactions were quantified by the sum of induration and the number of positive responses.
Main Results:
- Elderly subjects exhibited significantly lower DCH scores compared to young controls.
- Only 7% of the elderly nursing home residents tested were anergic.
- Despite blunted skin test responses, cellular-mediated immunity was largely intact in most geriatric subjects.
Conclusions:
- The Multitest CMI is a highly effective tool for DCH testing in elderly individuals with chronic conditions.
- The study demonstrates that cellular-mediated immunity remains intact in most geriatric patients, even with diminished skin test reactivity.