Академический Документы
Профессиональный Документы
Культура Документы
Background
or the loss of independence
Eldely pts often
lack high-
affinity
antibody
responses to
infectious
agents &
vaccination
IMMUNOSENESCENCE
• The consequences of immunosenescence: elderly are
susceptible to infectious diseases
IMMUNOSENESCENCE
• Medical (lesser of insidence of hospitalization & complications)
and economic advantages (lesser expense → reduced
hospitalization cost as well as << treatment cost)
• Spesific protection
INFLUENZA IN ELDERLY
• Respiratory tract • The manifested non-specific
hyperreactivity and pneumonia signs and symptoms (delirium
are the common complication syndrome, postural instability
of influenza. and fall) may cause further
• complication of influenza in
• will result in reduced the elderly.
functional status, prolonged
recovery time (post-influenza • Influenza complication in
asthenia) with highdependency geriatric patient usually will
rate, or even sepsis and death. also affect the patient’s
dependency level. →that there
was decreased ADL
INFLUENZA IN ELDERLY
• The primary strategy for prevention
of influenza disease is vaccination.
• Although the vaccine is less efficacious
• Vaccines against influenza currently, in preventing clinical illness in older
a trivalent inactivated vaccine is used adults as compared to younger adults, it
(A/H1N1, A/H3N2, B) has been proved that it lessens the
severity of infection and is 80%
• Recently, quadrivalent vaccines effective in preventing death in this
became available, as two different B population
strains had circulated in parallel for
several years
INFLUENZA VACCINE
• Until now, pneumonia is the • The elderly is more vulnerable to
leading cause of death in infection as they own impaired
hospitalized geriatric patient. physiological immune system
and reduced lung function, i.e.
suppression of the cough reflex
• The prevalence of pneumonia at and decreased function of
acute geriatric ward of Cipto mucocilliary epithelial in the
Mangunkusumo Hospital in 2000 respiratory tract; therefore, the
was 54.8% with mortality rate risk of pneumonia in the elderly
reached 32.5%. increases.
PNEUMONIA IN ELDERLY
• Initial symptoms are not specific.
• The common constitutional symptoms are weakness, • patients usually have impaired functional
loss of appetite and no eagerness to do activities. state, which cause great dependency upon
other people or having high dependency
• Patients are usually admitted to hospital due to fall, level to perform their activities of daily
unconsciousness or exaggerated dyspnea.
living
• Physical examination may reveal acute confusional
state or delirium syndrome. • Pneumonia in geriatric patients often has
clinical presentation of postural instability,
• In many cases, the patient may experience various which may cause fall. Femoral fracture,
complications including respiratory failure, respiratory immobilization, incontinence, contracture,
acidosis, sepsis and even death. decubitus and sepsis are conditions
commonly found in geriatric patients with
• the healing process may be prolonged causing high pneumonia. → impaired quality of life in
medical and hospitalization cost. the elderly patients
PNEUMONIA IN ELDERLY
• A 23-valent polysaccharide vaccine (PPSV-23) has been
used for many years for older adults
PNEUMOCOCCAL VACCINE
Jenis Pneumococcal polysaccharide vaccine-23
(PPSV-23)
Dosis Dosis tunggal (0,5 ml) intramuscular atau
subkutan
Indikasi Seluruh dewasa ≥65 tahun, atau dewasa ≥19
tahun dengan faktor risiko tertentu. Dosis
perlu diulang setiap 5 tahun.
Kontraindikasi Reaksi alergi berat (seperti Anafilaksis)
setelah vaksinasi sebelumnya, atau terhadap
komponen vaksin
which has been licensed for Dosis Dosis tunggal (0,65 ml) subkutan
use in older adults in 2006, is
recommended in some Indikasi Seluruh dewasa ≥60 tahun, dengan atau tanpa kejadian
countries. herpes zoster sebelumnya. Vaksinasi juga dapat
diberikan pada individu dengan berbagai penyakit
• This vaccine has been shown
kronis, kecuali yang termasuk dalam kontraindikasi.
to induce antibody and T-cell
responses in the elderly and in Food and Drug Administration (FDA) telah menyutujui
a large study proved to be pemberian vaksin usia populasi berusia ≥50 tahun.
clinically efficient because Kontraindikasi Individu imunodefisiensi, termasuk tuberculosis
vaccination reduced the aktif
incidence of herpes zoster by Memiliki riwayat anafilaktik atau reaksi
51.3% in the total population.
anafilaktoid terhadap komponen vaksi
Herpes Zoster
10 hari setelah pemberian vaksinasi zoster.
Beberapa bank darah menyarankan untuk
Other Vaccines
• Despite major advances in the field of vaccinology over the last decades,
there are still possibilities for improvement, particularly concerning vaccines
for the elderly.
• Most existing vaccines are less immunogenic in the elderly and many
different strategies are currently pursued to optimize vaccine efficacy in the
elderly.
FUTURE CHALLENGES
• Older adults are at high risk for infectious diseases and
vaccination is an important preventive measure to
facilitate healthy aging.
Conclusion
THANK YOU