Table 1.

Allergy in the elderly: a panoramic view

• The elderly population is steadily increasing and issues related to his state of health will become a topic of increasing relevance. • With increasing age, numerous underlying physiological changes occur, and the risk of chronic diseases rises. At the same time allergy is increasing worldwide, and 5-10% of allergies is affecting elderly people. • Taking into consideration the dramatic increase of all forms of allergies during the last decades also in the elderly, they are considered a real "epidemic" of the XXIst century, being classified by the WHO as the fourth most frequent chronic diseases. • Despite the great importance of the problem, allergic diseases, compared to all other chronic diseases, are neglected and undervalued. • In old people a number of factors may contribute to trigger allergy and/or to disguise it, making it longer and difficult to achieve the right diagnosis and relief suffering persons often already affected by several other diseases and in presence of many other causes of frailty. • The multifaceted dynamics among multimorbidity, disease, and underlying physiological change, can result in health states in older age that are not captured by traditional disease classifications and not easily diagnosed. • Many epidemiological surveys have shown that the number of allergic patients in Europe and other developed and developing countries is increasing dramatically. A notable proportion of individuals with respiratory allergy in Europe are underdiagnosed, undertreated and dissatisfied with their treatment and among these most are elderly people. • Recently there has been a large increase in knowledge about the immunological processes that play a role in allergic diseases and about environmental exposure (irritants and allergens), a tendency that will continue, and this gain in knowledge has led to changes in diagnostic and therapeutic possibilities (component-resolved diagnosis, new forms of immunotherapy), and to a better understanding of the role and the possibilities of primary and secondary prevention (benefits and risks of allergen avoidance, infant feeding, application of pro-/prebiotics, risk of tobacco smoke, role of epigenetics).