Zusammenfassung
Zu Beginn des 21sten Jahrhunderts wird unser Gesundheitssystem nicht nur durch neuartige beziehungsweise wiederkehrende Infektionskrankheiten gefordert, sondern auch durch den demographischen Wandel, welcher derzeit in den Industriestaaten stattfindet. Von besonderer Bedeutung ist, dass Infektionserkrankungen bei älteren Menschen häufiger auftreten, einen schwereren Verlauf nehmen und charakteristische Merkmale hinsichtlich klinischer Präsentation und Behandlung aufweisen. Dies ist auf die Abnahme von Immunfunktionen zurückzuführen, welches kollektiv als Immunseneszenz bezeichnet wird. Die bedeutendsten altersassoziierten Veränderungen betreffen das T-Zell-System. Dies hat dementsprechend Auswirkungen auf die Wirksamkeit von Impfungen im Alter. Nichtsdestoweniger spielen Impfungen eine äußerst wichtige Rolle bei der Reduktion der durch Infektionserkrankungen verursachten Morbidität und Mortalität. Der vorliegende Artikel erläutert nun die Auswirkungen von Infektionserkrankungen auf ältere Menschen und vermittelt einen Überblick über den aktuellen Forschungsstand von Impfungen für ältere Menschen. Weiters soll dargestellt werden, welche altersassoziierten Veränderungen des Immunsystems für die verminderte Wirkung von Impfungen verantwortlich sind.
Summary
In the 21st century, public health is not only challenged by newly emerging and re-emerging infectious diseases but also by demographic developments that are taking place in many countries. Importantly, infections in the elderly are more frequent, more severe and have distinct features with respect to clinical presentation and treatment. This is due to a decline in the functions of the immune system referred to as immunosenescence. The most important age-related changes affect the T cell system. Although this derogates the protective effect of some vaccines, vaccinations are still considered the most cost-effective medical procedure for preventing morbidity and mortality caused by infectious diseases. The present article aims at outlining the impact of infectious diseases on the elderly and summarizing the progress made in the field of vaccinations of the elderly and how age-related changes within the immune system contribute to the decreased efficacy of vaccines.
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Herndler-Brandstetter, D., Cioca, D. & Grubeck-Loebenstein, B. Immunizations in the elderly: do they live up to their promise?. Wien Med Wochenschr 156, 130–141 (2006). https://doi.org/10.1007/s10354-006-0267-8
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DOI: https://doi.org/10.1007/s10354-006-0267-8