This review examines allergic rhinitis (AR) in elderly patients, covering epidemiology, diagnosis challenges, comorbidities (multimorbidity, frailty, polypharmacy), and management strategies in collaboration with ARIA guidelines.
No specific guideline exists for AR in the elderly; first-generation oral antihistamines should be avoided due to safety risks, while intranasal corticosteroids (INCS), second-generation oral antihistamines, intranasal H1-antihistamines (INAH), and INAH-INCS fixed combinations are recommended as first-line options.
Epidemiological data on AR in the elderly remain limited; the review does not present original trial data or quantitative outcomes, relying instead on existing evidence and expert consensus.
Avoid first-generation antihistamines in elderly AR patients due to serious side effects; prioritize INCS, second-generation oral antihistamines, or intranasal H1-antihistamines as first-line therapy. Always account for polypharmacy and drug-drug interactions when prescribing in this age group.
