Covid-19 Pandemic: Maximizing Future Vaccination Treatments Considering Aging and Frailty

Abstract

The COVID-19 pandemic is proving to be a multiplier of inequalities. Especially toward the elderly population. A voiceless scream that comes from geriatrics, nursing homes, hospices from all over Italy. They call it the silent massacre: from North to South, the bulletin of coronavirus positive-or already deceased-elderly people continues to grow exponentially without a chance to counter it. Population aging and chronicity are a question that needs to be addressed. Frailty is the most challenging expression of population aging, with major consequences for public health and clinical practice. It is a geriatric syndrome which consists in a state of higher vulnerability to stressors attributed to a lower homeostatic reserve due to an age-related multisystem physiological change. People over 60, and especially over 80, are particularly vulnerable to severe or fatal infection. Moreover, the age-related dysregulation of the immune system in the elderly (i.e., immunosenescence and inflammaging) results in poorer responses to vaccination. Physical frailty is an effective health indicator and it has previously shown to predict the response to the seasonal flu vaccine. These findings suggest that assessing frailty in the elderly may identify those who are less likely to respond to immunization and be at higher risk for COVID-19 and its complications. Moreover, cognitive frailty and neurocognitive disorders, mental health and reduced awareness of illness negatively impact on adherence to complex medication regimens among elderly patients. A worldwide research and development blueprint have been initiated to accelerate the development of vaccines and therapeutics for the COVID-19 outbreak. Considered the above, I suggest the importance to consider aging in thinking about future Civud-19 vaccination and treatment, focusing on the possible impact of physical and cognitive frailty.

Expressive Flexibility and Dispositional Optimism Contribute to the Elderly’s Resilience and Health-Related Quality of Life during the COVID-19 Pandemic

“…Indeed, each of these components may concur as a protective factor towards physiological, or even to a successful, aging, as well as a vulnerability factor that progressively exposes the individual to reduced independence [ 56 ] and increased risk of adverse age-related outcomes [ 57 , 58 , 59 , 60 ]. Therefore, the implementation of preventive strategies should be aimed at facing the consequences of the pandemic not only on the physical health of the elderly [ 61 ] but also on their HRQoL and their psychological wellbeing.…”

Global Population Aging, National Development Level, and Vulnerability to the Pandemic

“… 61 Future COVID-19 vaccination policies implemented by developing countries need to consider aging and physical and cognitive frailty associated with aging, since dysregulation of the immune system in older adults can cause poorer responses to vaccination. 62 …”

Frailty, Vulnerability, and Plasticity: Towards a New Medicine of Complexity

“…There is no single way of ageing, but there are as many different ageing processes as there are humans [2]. Indeed, ageing is a gradual and continuous process of natural mutation for which many bodily functions begin a gradual decline [2].…”

“…There is no single way of ageing, but there are as many different ageing processes as there are humans [2]. Indeed, ageing is a gradual and continuous process of natural mutation for which many bodily functions begin a gradual decline [2]. The life-span perspective recognizes changes in the functional state as characteristic of the human being ageing process [3] and are considered characteristic of the pure ageing.…”

“…A l bio-psycho-social model can help us to define the most appropriate interventions to promote health in terms of the best possible quality of life. This approach attributes health to the intricate and variable interaction of biological, psychological, and social factors [1,2].…”