高齢者のかかりやすい感染症とは!?
高齢者は感染症にかかりやすい存在であることはご存じでしたか。とはいっても、感染症の種類はいくつもあるもの。そこで、当記事では感染症とはなにか、高齢者のかかりやすい感染症についてもご紹介していきます。
目次
感染症とは?高齢者が感染症にかかりやすいって本当?
感染症とはなんでしょうか。
感染症は、病気を起こす病原体が、人に定着してしまい、症状を起こすことをいいます。おもな感染症の症状として、「発熱」「下痢」「嘔吐」「咳」が挙げられます。
みなさんもよく聞く、風邪や食中毒も感染症のひとつです。しかし、これらの病原体は、どんな種類のものであるか、水や空気中など、どこから持ち運んでいるのか、病原体が人に入った場合でも、その人の健康状態などにり、感染症にかかってしまうかどうかは異なってきます。基本的に、健康な人は細菌や微生物などの異物から、自身の身体を守るための仕組みである「免疫機能」が備わっています。さて、ここで高齢者の身体の状態を考えてみます。
高齢者は、加齢に伴い、免疫機能も落ちてゆき、自己の身体を守る働きが弱くなってしまいます。このことから、高齢者は、若年者と比較し、感染症にかかりやすくなることがわかります。高齢者が感染症にかかりやすいのは、若年者よりも免疫力が低下していることからだと言えます。高齢になると、あらゆる病原体の影響を受けてしまい、病気にかかりやすくなることがあると言われています。
高齢者のかかりやすい感染症ってあるの?
感染症の数はいくつもあり、現在も流行が続く新型コロナウィルスのように新しく生まれ、その種類も増えています。その中でも、高齢者がかかりやすい感染症が存在します。
ここでは、高齢者のかかりやすい感染症について次に紹介します。
・肺炎
・尿路感染症
・インフルエンザ
・感染性胃腸炎
・結核
・腸管出血性大腸菌
・肺炎
高齢者の肺炎は、多くの場合、誤嚥性肺炎であると言われています。口の中の中に存在する菌を唾や痰など一緒に飲み込んでしまい(誤嚥/ごえん)、肺にはいることで、肺炎をおこします。咳や痰、肺の炎症からくる胸の痛みや息苦しさと言った症状が出現し、熱がでることもあります。高齢者はこの熱が出づらいことから、肺炎と診断されず、見過ごされてしまう場合があり、重症化してから発見される場合があります。
肺炎は、主に病原体からくる感染により、肺が炎症を起こします。インフルエンザ菌、黄色ブドウ球菌、肺炎球菌と言った病原体が入り感染します。肺炎の原因となる病原体も他にも存在しますが、抵抗力の弱った高齢者がかかり易いということがわかっています。
・尿路感染症
高齢者は加齢により、多くの疾患を抱えることがあります。その疾患が原因で、病原体からの防御機能が弱り、尿道、膀胱、尿管などの尿を通る「尿路」に感染を起こしてしまうことがあります。これが尿路感染症です。よく見られるものは、尿が体外にでる、尿道口から菌が入ってしまい、尿が濁り、排尿時通、残尿感や頻尿になる膀胱炎があります。
また、高齢者は尿路感染症を再発するなど、繰り返し発症することが多く、治りづらい傾向があります。いずれも、尿路の防御機能の低下が原因だと言われています。
特に寝た切りでオムツを使用している場合は、排泄後の尿がオムツ内に残り、細菌の繁殖から尿路感染症を起こしやすいことがわかっています。また、バルーンカテーテルを使用している方も、カテーテルを通して、尿道に細菌が逆流し、尿路感染症につながります。いずれも尿路感染症になりやすい状況であると言えます。
・インフルエンザ
インフルエンザは、インフルエンザウイルスに感染することで罹患します。主な症状としては高熱(39℃以上)、悪寒、倦怠感、筋肉痛や関節痛が出現します。しかし、高齢者の場合、高熱がでないパターンも見受けられます。
インフルエンザにはA型とB型の2種類があり、A型は毎年、流行する型のタイプが異なることが分かっています。インフルエンザに比較的有効な対策としては、ワクチンが挙げられますが、毎年流行する型のタイプを事前に予測して作られているため、必ずしも有効であるとは言えません。
インフルエンザの恐ろしい点は、合併症により肺炎や脳炎などを起こし、生命に関わるほど、重症化してしまうケースも見受けられることです。
・感染性胃腸炎
胃腸炎のなかでも、細菌やウイルスなどの病原体が原因で発症しますが、感染性胃腸炎で、主にウィルスによる胃腸炎を総称しています。ノロウィルス・ロタウィルス・サポウィルス・アデノウィルスなどが感染性胃腸炎になる主な原因ですが、中でも高齢者に多いのは、ノロウィルスによる感染だと言われています。
加熱が不十分な貝類を食べたり、ノロウィルスに感染している人の便や吐物からウィルスを吸い込むことで感染します。ノロウィルスは非常に感染力の強いウィルスであることがわかっています。しかし、ノロウィルスに対するワクチンは存在しません。再発もしやすく、注意が必要です。
・結核
結核は、空気からの感染により、結核菌が体内に入ることで発症します。主に細菌は、肺の内部で増えることがわかっており、咳痰・微熱・倦怠感といった、一見風邪のような症状が多いと言われています。結核菌は肺以外にも、脳やリンパ節といった、身体の他の部分にも影響が及ぶ場合があります。高齢者の場合、これまでに結核菌に感染したことがある場合、体の免疫食が弱った場合に、菌が活性化する場合もあります。結核の予防注射は小児期に行うもので、BCGが存在します。
・腸管出血性大腸菌(O-157)
もともと大腸菌人の腸内に存在しているもので、多くは問題をおこすことがありません。しかし、中には、下痢や嘔吐などの消化器症状を起こすものがあり、病原性大腸菌と呼ばれ、場合によっては合併症も発症させてしまいます。特に腸管出血性大腸菌o-157は強い毒素を出すと言われており、激しい腹痛や下痢、便に血が混じるなどの症状を呈します。また急性脳症や尿の減少や四肢の浮腫み、頭痛やけいれんなどの症状を引き起こす溶血性尿毒症症候群(HUS)と言った重大な合併症も発症することがあります。
腸管出血性大腸菌O157では、生の肉や、井戸水などから検出されており、食品を洗浄したり、生の食品は食べないようにし、加熱を徹底することなどが大切であると言われています。
感染症にならないようにするためには?
高齢者になることで、免疫機能が落ちてしまうことは、やむを得ないことですが、感染症にならないようにするために、免疫機能を維持させることが大切です。感染症にかかりづらい身体を作るためにも、次の点を心がけることをお勧めします。
栄養バランスのよい食事を心がける
栄養バランスの良い食事は、 穀類の「主食」をベースとし、「主菜」は肉や魚、卵やたんぱく質を中心としたメインディッシュを。「副菜」は野菜をたっぷりと、きのこや海藻なども取り入れ、「汁物」を組み合わせましょう。理想は和の定食をイメージします。また、各自の一日の必要摂取量(*1)から逆算し、カロリーが過剰にならないようにすることと、汁物は塩分過剰になってしまう傾向にあるため、一日1杯にします。主菜も副菜も、多種多様な品目を取り入れてみましょう。
適度な運動を行う
体に適度な負荷をかけることができる運動を行います。おすすめはウォーキングです。必要な物品もありませんし、自身で負荷をかける強度も、比較的コントロールしやすいからです。適度な運動は筋力の維持や、呼吸機能の向上だけでなく、心身のリフレッシュも兼ねており、様々なメリットがあります。
リラックスできる環境を作る・ストレス発散の機会を作る
神経と免疫機能は密接な関係があります。ストレスに関係があるのは、「自立神経」で、自律神経は「交感神経」と「副交感神経」から成り立っています。緊張が続いたり、ストレスを非常に感じている場合、交感神経が優位になります。交感神経が優位になると、血管が収縮したり、全身に酸素を運搬することができなくなってしまったり、栄養の運搬が遅くなるなど、免疫機能が正しく機能しなくなる原因となります。そのため、副交感神経を働かせるために、リラックスする環境を作ったり、ストレス発散の機会を作ることを習慣づけることが大切です。
睡眠・休息をしっかりととる
心身の充分な睡眠・休養は、免疫細胞を休ませるためにも大切な時間です。免疫機能は十分な睡眠。休養との深く関わりがあることがわかっています。風邪をひいた際に、体がだるくなったり、眠気を感じたことはありませんか?風邪は病原菌やウィルスにより引き起こされますが、体は、この病原菌やウィルスと戦うために、免疫機能を働かせます。その際にだるさや眠気と言った症状を感じ、身体を休ませようとしているからです。
まとめ
高齢者は加齢により、病原体からの防御機能が低下してしまうことで、感染症にかかりやすくなります。感染症は数多くありますが、中でも肺炎、尿路感染症、インフルエンザ、感染性大腸炎、結核、腸管出血性大腰菌は、高齢者がかかりやすい感染症だと言われています。感染症にかかりづらい身体を作るためには、免疫力を維持、向上させることが大切です。免疫力の維持、向上のためには、適度に運動を行い、睡眠や休息を取るなど日常生活の工夫で対処することができます。
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