Fever and the Ageing Immune system, A Review

Abstract

Whether to treat fever in the elderly, is a question that has not yet been answered. This review examines the available evidence so far, to arrive at a comprehensive picture about this question. Aged population are a special category due to their lower basal body temperature, blunted fever response and existing co morbidities. The aging immune system undergoes many changes in all its faculties, which alters its ability to mount an efficient acute inflammatory response. In such a scenario, fever is mostly absent and there is a need to revise the fever criteria in the elderly. Having said that, the most successfully aging, centenarians, mount efficient febrile response during infections, indicating that aging itself may not be the reason for the reduced febrile response. Holistic medicine, such as homeopathy, views the fever scenario differently and advocates interference only when the immune system is helpless. The ‘levels of health theory’ explains that the healthiest benefit from fever while those with reduced immunity suffer from it. This theory may prove to be an invaluable clinical tool to arrive at definite clinical guidelines concerning the treatment of fever, especially in the elderly. However, it requires scientific investigation before it can be used as a clinical tool. There is no conclusive evidence on whether fever must be treated or not in the elderly and whether holistic medicine may have a solution to this dilemma. This is a research gap that needs to be filled with quality studies in the current health scenario.