No abstract

From the clinical perspective, asthma in the older patient may be difficult to diagnose because of the non-specificity of presentation and the wide range of differential diagnoses. Prior to confirmation of asthma in the older patient, both respiratory and cardiac investigation may be necessary. Polypharmacy is inherent in treating older people and accurate drug histories are essential in order to identify patients with drug-induced bronchospasm and avoid interactions with asthma medication. Patient and carer education is vital, and a structured approach to follow-up which includes measurement of lung function and assessment of inhaler technique should be carried out in every asthmatic regardless of age. Finally, there is a great need for health services and those in the commercial sector that are involved in asthma care to ensure that future research and development rises to the challenge of an ageing population.

Airways obstruction is a common problem in the elderly and may be overlooked because of the high prevalence of other disorders such as cardiac failure that have similar presentations. Identification of airways obstruction and assessment of responsiveness to treatment would be improved if simple tests of pulmonary function were performed on a routine basis in elderly patients complaining of respiratory symptoms. In the treatment of airways obstruction, particular attention needs to be paid to the patients' inhaler technique, their understanding of when the drugs should be taken and the effect that the therapy is having on symptoms, exercise tolerance, and quality of life as well as pulmonary function.