Prevalence and risk factors for food allergy in elderly individuals

• Autor(a) principal: Dias, Inês Laia
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/8706
• topic: Elderly; Epidemiology; Food Allergy; Systematic Review; Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina

Background: Various studies suggest that the prevalence of food allergy may be increasing worldwide. Results regarding the prevalence and features of adverse food reactions in the elderly have, however, scarcely been analysed in the literature. Thus, the objective of the present systematic review is to describe the prevalence of food allergy, as well as its risk factors, clinical features and most frequently involved foods. Methods: This systematic review protocol was registered at the PROSPERO online platform (https://www.crd.york.ac.uk/prospero/) number CRD42018102140. We conducted a systematic review and meta-analysis on the prevalence and risk factors for food allergy in elderly individuals. We searched international electronic databases including MEDLINE, EMBASE, Cochrane Library, CINAHL, AMED and ISI Web of Science, as well as clinical trials databases for published, unpublished and on-going studies from 1980 to 2019. There were no restrictions on the language or geography of publication. The Critical Appraisal Skills Programme (CASP) quality assessment tool was used to appraise the methodological quality of the included studies. A descriptive summary with data tables was elaborated, and when clinically relevant and statistically adequate, a meta-analysis using random-effects modelling was carried out, given the expected clinical, methodological and statistical heterogeneity of the selected studies. The PRISMA checklist guided the reporting of the systematic review. Results: The prevalence of food allergy in the elderly was 11.2% for self-report, lower than that of SR + food-specific IgE levels (25.4%) and SPT (24.3%), and higher than that in children (when data were available) for all methods of outcome assessment, and that in adults only with self-report. No results were obtained regarding the time and geographical tendencies, predominant foods, risk and prognostic factors, and clinical manifestations of food allergy in the elderly. There was great heterogeneity both in the systematic review and the meta-analysis, which was highest for milk and derivatives (I2=97.142%), moderate for peanuts (I2=44.342%) and lowest for others (I2=0.000%). Conclusions: This systematic review allowed us to draw up-to-date estimates of the prevalence of adverse food reactions in elderly individuals, worldwide. The data reported in all selected studies did not allow an analysis regarding time and geographical trends, predominant foods, risk and prognostic factors, and clinical manifestations of food allergy in the elderly. Our review only involved studies that fully met the inclusion criteria and included analysis of study biases that might affect exposure and outcomes.