Understanding Shingles and the Aging Immune System
Shingles, also known as herpes zoster, is caused by the varicella-zoster virus (VZV), the same virus that causes chickenpox. After a chickenpox infection, VZV remains inactive in the nervous system. The virus can reactivate later in life, leading to shingles in about one in three adults. The risk of shingles increases significantly with age, particularly after 50, raising the question: Do people in their 80s get shingles? The answer is yes, and it's a significant health risk for this age group.
Why the Risk Rises with Age
The primary factor for increased shingles risk in older adults is immune senescence, the natural age-related weakening of the immune system. This decline makes the immune system less effective at suppressing the dormant VZV, allowing it to reactivate and cause shingles.
Conditions and treatments that further weaken the immune system can increase an older adult's risk of shingles, including chronic diseases like diabetes or cancer, immunosuppressive medications (such as those for cancer or organ transplants), and long-term stress.
Symptoms and Clinical Presentation in Older Adults
Shingles typically starts with pain, burning, tingling, or itching on one side of the body before a rash appears. This rash develops into fluid-filled blisters that crust over and heal within a few weeks. The rash often appears on the torso but can occur on the face, eye, or ear.
In older adults, symptoms can be more intense, including more severe pain and systemic symptoms like fever. The risk of the rash affecting the eye is also higher in older individuals and requires immediate medical attention.
Increased Risk of Complications in the Elderly
Older adults face a greater risk of severe shingles and complications. The most common complication is postherpetic neuralgia (PHN), characterized by persistent nerve pain long after the rash heals. PHN can severely impact quality of life.
Other potential complications for older adults include vision loss from ophthalmic shingles, neurological issues like facial paralysis or brain inflammation, secondary bacterial skin infections, and potentially an increased risk of stroke or heart disease.
Prevention with the Shingles Vaccine
Vaccination is the most effective way for older adults to prevent shingles. Shingrix, the recommended vaccine for healthy adults 50 and older, is over 90% effective at preventing shingles and PHN. It's administered as a two-dose series.
| Feature | Shingrix (New Vaccine) | Zostavax (Older Vaccine - Discontinued in the U.S.) |
|---|---|---|
| Approval | Oct 2017 | Prior to 2017, discontinued Nov 2020 |
| Effectiveness (70+ years) | >90% effective | 41% effective |
| Doses | 2 doses, 2-6 months apart | 1 dose |
| Type | Non-live recombinant | Live attenuated virus |
| Prevention of PHN (70+ years) | 90% effective | Much lower efficacy |
Even if you've had shingles or the older Zostavax vaccine, getting Shingrix is recommended for its superior protection. For more information, visit the CDC website.
Treatment and Care for an Outbreak
If shingles is suspected in an older adult, prompt medical attention is vital. Antiviral medications are most effective when started within 72 hours of the rash onset, helping to reduce severity and duration.
Symptom management may include over-the-counter or prescription pain relief, antihistamines, topical treatments like compresses or lotions, and wearing loose clothing. Supportive care from caregivers is important during recovery, addressing physical needs and emotional distress.
Conclusion: Taking Action for Senior Health
Do people in their 80s get shingles? Yes, and it carries increased risks. However, the Shingrix vaccine provides a highly effective preventative measure. For those who do contract shingles, early medical intervention and supportive care are key to managing the illness and reducing the likelihood of long-term complications. Understanding these risks and preventative steps is crucial for maintaining senior health and well-being.
