John J O Accarino, Philip Mendez, Jane C Y Wong, Philip H Li
There are growing challenges when evaluating drug allergy in the aging global population. Older adults are frequently affected by polypharmacy, multimorbidity, and limited recall of the index reaction. Cultural beliefs, preference for alternative medical systems, and decreased mobility may lead to delays before even scheduling an appointment. Cognitive impairment and inability to provide informed consent can lead to reliance on proxies or family members. Skin aging and physical frailty may present logistical barriers in office evaluation, requiring a personalized or cautious approach. We advocate for geronto-allergy care models that integrate geriatricians, allergists, pharmacists, and caregivers to improve outcomes. We also emphasize the need for legislative support, international collaboration, and evidence-based training to standardize and optimize care.