ABSTRACT
During the 20th century, infectious disease mortality has declined gradually, yet large periodic spikes in the infectious disease curve suggest that factors that inuence the emergence and reemergence of infectious diseases are dynamic.1 Human life expectancy has increased signicantly, and as a result, the number of persons aged over 65 years has been increasing rapidly in most countries. In the United States, >12% of the population were 65 years or older in 2011.2 Between 2000 and 2010, the population aged 65 and older grew by 15.1%.3 Increase in the population aged 65 or older emphasizes the importance of better understanding the infectious diseases
Introduction ............................................................................................................ 357 Infectious Diseases in the Elderly .......................................................................... 358 Immunological Changes in the Elderly .................................................................. 358
Aging and Innate Immunity .............................................................................. 358 T cells and Aging .............................................................................................. 359
Changes in Nutritional Status in the Elderly ..........................................................360 Inuence of Infection on the Nutritional Status ..................................................... 361 Inuence of Nutritional Status on Host Defense against Infection ........................ 361
Vitamin D and Infection .................................................................................... 361 Vitamin E and Infection .................................................................................... 362 Selenium and Infection ..................................................................................... 363 Zinc and Infection ............................................................................................. 363
Nutrient Supplementation and Infectious Disease in the Elderly ..........................364 Vitamin D Supplementation and Infectious Diseases .......................................364 Vitamin E Supplementation and Infectious Diseases ........................................364 Selenium Supplementation and Infectious Diseases ......................................... 369 Zinc Supplementation and Infectious Diseases................................................. 370 Multivitamin and Multimineral Supplementation and Infectious Diseases ...... 371
Conclusions ............................................................................................................ 371 References .............................................................................................................. 372
in the elderly. Despite a general decrease in infectious disease mortality during the 20th century, increases in the infectious disease mortality among persons aged >65 years have been reported during the 1980s and 1990s due to increases in pneumonia and inuenza deaths.1 Therefore, infectious disease is a continuing threat to the older population. Multiple factors, including decline of immune function, comorbidities, changes in nutritional status due to alterations in intake and metabolism of nutrients, contribute to the increased susceptibility to infection in the elderly. In this chapter, we discuss the changes in immunity and nutritional status that accompany aging and the interaction between nutrient and infection. We review how nutritional status inuences susceptibility to infectious diseases and the impact of nutritional supplementation on infectious diseases in the elderly.
