Elderly shingles: Recognizing symptoms, potential problems, and available treatments
In the realm of viral infections, shingles, also known as herpes zoster (HZ), poses a significant threat, particularly to older adults. This condition is caused by the reactivation of the varicella-zoster virus (VZV), the same virus responsible for chickenpox [1].
Shingles is more prevalent among the elderly, with over half of all shingles cases occurring in adults aged 60 or older [2]. This statistic underscores the importance of understanding the risks and complications associated with shingles in older adults.
One of the most concerning complications is postherpetic neuralgia (PHN), a continuous, chronic nerve pain that can persist even after the blisters have healed and the rash has cleared up. This painful condition affects over half of people who have shingles, but it is particularly severe and more common in older individuals. In fact, PHN occurs in 5-30% of those aged 50 and older, with the pain often being more intense, longer-lasting, and potentially lifelong in older individuals, causing insomnia, mobility issues, and chronic discomfort [1][4].
Older adults also face a higher risk of specific complications such as herpes zoster ophthalmicus (ocular shingles), which can lead to inflammation, corneal ulcers, vision impairment, and, in severe cases, blindness or facial paralysis [1][4]. Neurological issues, including facial paralysis, hearing loss, balance problems, and more serious neurological or vascular events such as stroke or cerebral hemorrhage, are also more prevalent in older patients [1][4].
Older individuals are also more prone to bacterial skin infections, which can impede healing and increase scarring, and they typically experience more intense pain during the active shingles phase [1]. Furthermore, older adults with weakened immunity are at a higher risk of disseminated herpes zoster, a condition where the rash affects multiple dermatomes [4].
In contrast, younger adults generally experience milder symptoms and fewer complications, though those with weakened immune systems remain at elevated risk [2][3].
The increased severity of complications and prolonged recovery in older adults underpin public health recommendations for shingles vaccination starting at age 50, which significantly reduces the risk of shingles and postherpetic neuralgia [1][2]. The Shingrix vaccine is a valuable tool in preventing shingles in adults ages 50 years and older.
It is crucial for older adults to be aware of the increased risks associated with shingles and to take steps to protect themselves. By understanding the risks and seeking preventative measures, such as vaccination, older adults can significantly reduce their chances of experiencing the severe complications associated with shingles.
References:
[1] Centers for Disease Control and Prevention. (2021). Shingles. Retrieved from https://www.cdc.gov/shingles/index.html
[2] National Institute on Aging. (2021). Shingles. Retrieved from https://www.nia.nih.gov/health/shingles
[3] Mayo Clinic. (2021). Shingles. Retrieved from https://www.mayoclinic.org/diseases-conditions/shingles/symptoms-causes/syc-20351484
[4] Johns Hopkins Medicine. (2021). Shingles. Retrieved from https://www.hopkinsmedicine.org/health/conditions-and-diseases/shingles
