The aim of this study is to characterize the immune profile of frail and healthy aged individuals and investigate their immune responsiveness including the response to influenza vaccine over an 18-month period. The project will include a longitudinal study to define immune signatures and multi-parameter profiles associated with frailty and may lead to the identification of predictive markers of evolution to frailty and Immunosenescence in the elderly.
With better healthcare available and improved accessibility, people are living longer. However, a majority of older persons cannot be considered to be aging well. Approximately 70% of those aged 85 years or older require frequent long hospitalizations because of their increased susceptibility to infections, cancers, dementia, and other age-related health problems, along with overall loss of function and autonomy associated with old age. Previous studies have shown that vaccination against influenza, which significantly reduces all-cause mortality in the elderly (65 years and older), was less immunogenic and effective with age. Frailty, a geriatric syndrome associated with low functional activity, weight loss, exhaustion, disability, decreased resilience to stressors, has been shown to increase risk for adverse outcomes and death. Better understanding the relationship between aging and waning immune responsiveness will enable the development of strategies to improve response to vaccination in the elderly and reduce morbidity and eventually mortality associated with age related complications and outcomes such as infectious diseases or frailty. A comprehensive analysis of the immune phenotype and function after antigenic challenge in older individuals would be a unique approach to understand (i) the potential associations between aging, impaired immune function and transition to frailty, (ii) which components of the immune system are altered with aging (innate vs adaptive immunity) and (iii) if early and/or late immune responses are preferentially altered with aging and frailty.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
240
To describe the humoral immune response to Vaxigrip (IM) vaccination at Day 0 (baseline) and Day 28 according to the age and frailty status at baseline (i.e. in each study group) for each Influenza strain.
Moral Neighbourhood Link @ Telok Blangah
Singapore, Singapore
National University Hospital
Singapore, Singapore
THK Seniors Activity Centre @ Henderson (Satellite 93)
Singapore, Singapore
Moral Neighbourhood Link (Bukit Merah View)
The Immune Responsiveness of Elderly Subjects when Administered Influenza Vaccination as Measured by HAI
Hemagglutination Inhibition (HAI) titer
Time frame: 18-month period
Cellular Immune Response and Inflammatory Profile of elderly subjects when administered influenza vaccination - Flu-Specific T cells
% Flu-specific T cells out of total PBMCs
Time frame: 18 months
Flu-Specific B Cell Response
No. of flu-specific B cells quantified out of 1x105 PBMCs
Time frame: 18 months
Inflammatory Markers
Quantitative (pg/mL analyte, picogram of analyte per milliliter of plasma)
Time frame: 18 months
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Singapore, Singapore
THK Seniors Activity Centre @ Beo Crescent
Singapore, Singapore
SARAH Senior Activity Centre
Singapore, Singapore
THK Seniors Service @ Taman Jurong
Singapore, Singapore
TaRa @ Jurong Point, Jurong West Central 2
Singapore, Singapore
Outpatient Clinic, St Luke's Hospital
Singapore, Singapore