The impact of immunosenescence and inflammaging on the diagnosis of allergic diseases in older adults: protocol for a scoping review

This scoping review aims to explore how immunosenescence and inflammaging influence allergic sensitization and the interpretation of allergy tests in older adults. Aging is associated with changes in both innate and adaptive immunity, including reduced immune responsiveness and chronic low-grade inflammation, which may alter the presentation and diagnosis of allergic diseases. The review focuses on allergic conditions such as allergic rhinitis, asthma, chronic rhinosinusitis, atopic dermatitis, and drug allergy in adults aged 60 years and older. It aims to map existing evidence on age-related changes in total and specific IgE levels, allergen sensitization, inflammatory phenotypes, and the clinical relevance of conventional allergy diagnostics such as skin prick tests and serum specific IgE. The expected outcome is to identify common patterns showing that aging may reduce IgE-mediated sensitization while promoting non-type 2 inflammation and altering the interpretation of allergy tests. Rather than simply having less allergy, older adults may present with an altered allergic phenotype, which may require age-adapted diagnostic approaches. The review will also help identify gaps in current research and support future studies on allergy diagnosis in aging populations.