Allergic Rhinitis in the Elderly. In Collaboration With the ARIA Guidelines

Area of Science:

• Otolaryngology
• Geriatrics
• Allergology

Background:

• Rhinitis in the elderly presents unique clinical challenges due to multimorbidity, frailty, and polypharmacy.
• Allergic rhinitis (AR) in older adults is frequently intertwined with non-allergic rhinitis (NAR).
• Symptoms like nasal dryness and congestion without clear triggers can lead to underrecognition.

Purpose of the Study:

• To highlight the complexities of diagnosing and managing rhinitis in the elderly population.
• To emphasize the need for person-centered treatment strategies.
• To review current therapeutic options and safety considerations for elderly patients with AR.

Main Methods:

• Review of existing literature on rhinitis in the elderly.
• Analysis of age-related changes affecting nasal function and symptom presentation.
• Evaluation of current treatment guidelines and pharmacological safety profiles.

Main Results:

• AR in the elderly often presents atypically, complicating diagnosis.
• Age-related nasal changes can influence symptom perception and presentation.
• First-generation antihistamines should be avoided due to safety concerns.

Conclusions:

• Management of AR in the elderly requires careful consideration of comorbidities and polypharmacy.
• First-line treatments include intranasal corticosteroids (INCS) and second-generation oral antihistamines.
• Digital health and artificial intelligence show promise for future AR management in this demographic.