Wednesday, May 27, 2020

Why Are Elderly More Susceptible to COVID-19?

by Dr. Iva Lloyd, ND

Over 80% of deaths due to COVID-19 have been in those over the age of 70. Although there is some variability based on country, the fatality rate for those in their 40's is about 0.4% and it is just over 1% for those in the 50's.  The fatality rate jumps to about 8% for those in their 70's that contract COVID-19 and can be as high as 15% for those over 80 years of age that have the virus. Those of any age that have co-morbidities and are in institutions are the greatest risk.

As we have seen, people of all ages contract COVID-19.  Most people experience no symptoms or mild symptoms that don't require hospitalization or medical treatment. When we see the tremendous impact that COVID-19 is having on the elderly it is imperative to delve into this situation in more detail and to understand the various factors that are contributing to this situation.  We have all unfortunately heard of the issues around the management of some old-age homes, this blog focuses on other factors that contribute including age itself, co-morbidities, nutrient deficiencies, lack of movement, stress and isolation and air quality.

Understanding why the elderly are more susceptible to dying from COVID-19 is a complex problem that will require a multi-factorial approach on an ongoing basis.

Age Itself

As people age their ability to fight infections decreases.  Older people are generally not as good at reacting to microorganisms that they haven't encountered before. They have less immune chemicals to fight pathogens, such as viruses and their immune system is slower and less effective.  This gradual deterioration of the immune system is referred to as immunosenscence and there is a concern that older people who have survived COVID-19 may not have the same immune memory as younger people exposed to COVID-19 and may be at greater risk of contracting the virus again.

It is important to recognize the difference between chronological age and biological age.  Chronological age is your actual age based on date of birth.  Biological age is the accumulation of your genetics, lifestyle factors, health habits, accidents and conditions that you have encountered throughout your life.  Some people in their 70's and 80's are in better health and have more resiliency or vitality than people in their 50's that have poor lifestyle habits and chronic conditions that they are managing. When deciding if you or a loved one is at high risk, the biological age will be more accurate.

Nutrient Deficiencies

Research has shown that nutrient deficiencies are a global problem. The elderly and those that are institutionalized are more likely to be nutrient deficient.

Although nutrient deficiencies are more common with age, this is a problem as there are a number of nutrients that are required for the immune system to function properly.  Vitamin A, Vitamin C and Vitamin D, Omega 3 Fish Oil, Selenium, Zinc and Melatonin are all essential nutrients in immune function. When a person, of any age, is deficient in essential vitamins, minerals and nutrients, what we find is that the immune system is not able to efficiently handle a virus or pathogen that it encounters.

It is common for dietary habits to change with age.  If that change includes a decrease in fresh fruit and vegetables and lean protein then nutrient deficiencies will result. Immunosenescense and chronic inflammation are correlated with nutritional deficiencies.  Maintaining adequate nutritional levels throughout a person's lifetime, whether through diet or supplementation, is essential for optimal health.

Check out blog: Food and Immune Health .

Lack of Movement

Movement is required for every function in the body.  It promotes proper blood and lymphatic circulation which keeps the cells of the immune system functioning and moving.

Movement may actually help flush pathogens out of the lungs and the airways.  It also supports the role of white blood cells in fighting disease. Moderate movement is associated with immune health.  Walking 20 minutes a day, bicycling, swimming, playing golf and other gentle types of movement are best for immune health.

As COVID-19 is impacting the cell's ability to carry oxygen, it is not surprising that the elderly that are institutionalized and generally less active are more affected.  When active, be cautious about wearing a mask. Although the new trend is for people to wear masks often, they can actually be detrimental - especially if worn while exercising.  Here is some update information on the pros and cons of masks.

Check out our blog: Movement - Top 5 Things to Remember

Stress and Isolation

The connection between stress and a weakened or compromised immune system is well understood.  When a person is under a lot of stress the immune system's ability to fight off infections is reduced. For some people this time of isolation has been an opportunity to recoup and to catch up on sleep and and tasks around the home.  Some people have welcomed the opportunity to work from home and spend time with their family and loved ones.

For others, the COVID-19 pandemic has been an unyielding stressors.  For many elderly people the fact that they have not been able to socialize with their family and friends has been a tremendous physical and emotional burden. Seniors are also more likely to be institutionalized and isolated.

The impact of stress and isolation can not be overlooked.  How a society treats older adults plays a big role in their risk from diseases like COVID-19. Isolation worsens everything and the current situation is a stark reminder of the importance of reaching out to those that are alone to let them know that we are thinking of them and that we are here to help.


Irrespective of age, co-morbidities such as diabetes, hypertension, cardiovascular disease and obesity are associated with increased risk of COVID-19 affecting the health of those affected at any age, especially in the elderly.

A person's ability to handle an infection partly depends on how stressed the body is in dealing with other chronic diseases. It is also important to note that nutrient deficiencies, a sedentary lifestyle and excess stress are also correlated with increased risk of chronic diseases. It is not surprising that elderly have a greater chance of having one or more chronic disease.

Addressing any co-morbidities is an important part of health promotion and disease prevention.

Blog: Don't Wait Until You're Sick To Get Healthy
Blog: A Crash Course on Respiratory Health

Air Quality

Addressing the management of COVID-19 must include assessing air quality especially as most people that have been infected have contracted the virus while inside. COVID-19 is more likely to spread indoors with hospitals and institutions having been associated with the most infections other than family transmission while at home. Air quality in institutions, especially those with high rates of infected individuals, is important to assess and address.

There has been a tremendous focus on washing hands frequently and cleaning surfaces, but there is growing research that in order to control COVID-19 the focus must also include the role of indoor air on disease transmission and occupant health. When the indoor air is dry, human occupants are more vulnerable to viral respiratory infections. Dry air can impair respiratory immunity by drying out the nose, sinuses and throat thus lessening the ability of cilia, the hair-like projections on cells lining airways, to expel viral particles. Dry air also lessens the effectiveness of the skin, eyes and other mucous membranes that are there to protect us from infections.

Over the next few months expect to hear more about ways that companies are improving the air quality in offices, air planes are making it safer to travel by addressing the air quality in planes, hospitals are assessing air exchange and there will be numerous recommendations on how to have healthier air quality at home. I expect that there will be a competition on what type of building or plane has the best and worst air quality.

The growing focus on air quality should be a reminder of the importance of spending time outside, ideally in a park or area with trees. When outside, especially with exercising, consider not wearing a mask so that you and your lungs can take advantage of everything that nature has to offer.

It is important that we look at why elderly are more susceptible to COVID-19 from as many angles as possible. Going forward we need to be aware of the health promotion and disease prevention strategies for each of us, including the elderly.