Staying Fit
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Fever. Fatigue. Muscle aches. A cough. In the age of COVID-19, it can be hard to know what exactly these symptoms point to. One major clue that they point directly to the flu: They came on abruptly (while those associated with COVID-19 tend to start out mild and gradually worsen).
But that’s not to say the flu always announces itself in the regular way — particularly among people over 65. In a study published in the Journal of the American Geriatrics Society, older patients were less likely than younger ones to report fever, cough and sore throat — arguably the most common flu symptoms — and as a result, weren’t diagnosed as quickly, if at all. That can be problematic if you’re 65 and older, since age alone ups your chances of getting hit much harder by a bout with the flu.
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Blame your immune system, which weakens with age, “so all infections are more severe, as are complications from infections,” says infectious disease specialist Purvi Parikh, M.D., a clinical assistant professor in the department of medicine at NYU Grossman School of Medicine. “Those over 65 may also have other chronic medical problems like heart disease and diabetes that make it even harder to fight off infections."
That explains why 70 to 85 percent of seasonal-flu-related deaths have occurred in people 65 and older; and 50 to 70 percent of seasonal-flu-related hospitalizations have happened among older adults, according to the Centers for Disease Control and Prevention.
“There’s always been clear knowledge that people over 65 are at an increased risk of severe complications from influenza, and hospitalization or death,” says Paul Auwaerter, M.D., clinical director of the division of infectious diseases and professor of medicine at the Johns Hopkins University School of Medicine. That’s why it’s important to get up to speed on flu symptoms and see your doctor if you have any or all of the following, especially if you have a medical condition such as heart disease or diabetes.
1. Fever
All kinds of things can make your body temperature venture north or south of the well-known benchmark of 98.6 F. For instance, it can go up when you exercise and down when you sleep. But a fever of 100.4 F or more is “a sign your body is responding to something dangerous physically and is trying to mount an immune response,” says Auwaerter.
But a fever doesn’t have to get that high to cause complications in people over 65, he adds. Why? “People who are older may have less buffer in terms of handling fever and the infection may worsen more rapidly than it might in a younger person,” he says.
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