Health Concerns for Elderly Travelers

Travelers over the age of 60 are more susceptible to a variety of health problems, but taking precautions can help guarantee a safe, rewarding trip.

Depending on the time of year, up to 30% of international travelers from the United States are 60 or older. Travel medicine specialists have unique concerns about this population for several reasons. Compared with younger adults, elders tend to have more trouble acclimatizing during travel; more difficulty in extreme temperatures, humidity, and high altitudes; increased risk for certain diseases; more underlying medical conditions; and a reduced response to new vaccinations and waning immunity from previous vaccines.

In an article in the May/June 2012 issue of the Journal of Travel Medicine, an international team of researchers reports on data collected prospectively from 1997 to 2009 with the goal of describing the epidemiology of travel-related disease. The researchers identified 7034 people over the age of 60 and compared them with a reference group of 56,042 patients aged 18 to 45. Unsurprisingly, they found that certain diagnoses were far more common in elders. These included lower respiratory tract infections, high-altitude pulmonary edema, phlebitis and pulmonary embolism, arthropod bites, severe malaria, rickettsiosis, gastritis, peptic ulcers, esophagitis and gastroesophageal reflux disease, trauma and injuries, urinary tract infections, heart disease, and death.

Pharmacists who counsel older travelers should take the opportunity to reinforce messages these elders should—but don’t always—hear from other clinicians and travel advisors. Crucial preventive measures for elders include:

• use of anti-thrombosis compression stockings
• sufficient hydration and exercise during long-distance flights
• attention to hand hygiene
• use of disposable handkerchiefs
• consideration of face-masks in crowded conditions
• progressive altitude acclimatization, especially in patients who have cardiac or pulmonary disease
• liberal use of insect repellents and nets in tropical climates

In terms of drug therapy, elders may benefit from acetazolamide as a preventive measure if they are traveling to higher altitudes. Many travel advisors also suggest that older travelers carry antibiotics for presumptive treatment of respiratory and urinary tract infections, and antacids for gastrointestinal concerns.

Current vaccination with influenza and pneumococcal vaccines is of utmost importance. The CDC, which considers pneumococcal disease a travel-related illness, reminds travelers that it occurs at higher rates in developing countries and is more common during winter and early spring, when respiratory viruses are circulating.

Refer all international travelers to the CDC’s Yellow Book for the most current information on travel-related health risks. This book is updated every two years, with the most recent update published this year.

Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.