Age Is Not Associated with Hospital Admission or Uncontrolled Symptoms of Asthma if Proper Treatment Is Offered

Abstract

Background: Aging modifies immune response and respiratory physiology. Few studies evaluate the effect of age on asthma. The aim of our study was to evaluate whether age is associated with uncontrolled symptoms and hospital admissions due to asthma in a setting where patients were receiving proper treatment. Methods: We enrolled 401 patients with uncontrolled asthma who were inhaled corticosteroid-naive. The follow-up period was 1 year. They received medications for asthma, performed spirometry, a symptoms questionnaire, and all emergency room visits and hospital admissions due to asthma were reported. The primary end point was hospital admission during the follow-up period. Results: Baseline data demonstrated that subjects >55 years of age had a later onset of asthma and a longer duration of symptoms. Adjusted logistic regression models demonstrated that older age at enrollment did not predict asthma control in the follow-up: hospital admission due to asthma [odds ratio (OR) 1.7 and 95% confidence interval (CI) 0.6-4.7], symptoms score (OR 0.6 and 95% CI 0.3-1.1) and emergency room visits due to asthma (OR 0.9 and 95% CI 0.6-1.3). Older age was associated with worse lung function (OR 1.8 and 95% CI 1.1-3.3). Conclusion: This study allows us to conclude that older age is associated with a later onset of asthma and a longer duration of symptoms. Age does not predict hospital admissions or poor control of asthma symptoms if proper treatment is offered. It does, however, predict worse lung function.

Is Asthma Control Really More Difficult to Achieve in the Elderly Patient?

“…The observation of a poorer lung function in older patients has been reported previously and it may reflect structural changes in the airways over time, particularly if asthma is uncontrolled [4,6,10]. However, despite poorer function, the study suggests that in older asthmatic patients who receive proper asthma management, particularly the regular use of inhaled corticosteroids (ICS), asthma control can be improved and acute care needs reduced [9]. …”

“…In the study by Ponte et al [9] recently published in this journal, 401 steroid-naïve patients, predominantly women and with mostly long-standing (particularly in the older patients), uncontrolled asthma, were followed up for 1 year. The authors conclude that older age at enrolment does not predict asthma control or emergency department (ED) visits at follow-up if asthma is treated properly, even when lung function is reduced.…”

“…Regular medical review is another factor that is considered to help maintain asthma control, in addition to education and the provision of an action plan for the management of asthma exacerbations [13]. It must also be noted that in the study by Ponte et al [9], only patients with at least 80% adherence to medication were included in the analysis.…”

“…Recognition of these conditions, particularly those affecting asthma control, is a key recommendation in current guidelines [14,15,16]. Of note is that in the study by Ponte et al [9], the older subjects with asthma had few symptoms of rhinitis; this was possibly related to a lower prevalence of atopy.…”

Profile of Pneumopathic Elderly Persons Admitted to a Pulmonary Rehabilitation Center

“…9 Elderly women were more associated with a diagnosis of bronchial asthma, a result also found in other studies. [10][11][12][13] Recognition of this pathological condition improves the diagnosis and notification process and optimizes diagnostic tests for these patients, as well as reducing errors during admission. 12 There is a significant association between asthma and allergies in women, 14 explaining the greater association identified between these two clinical profiles and women.…”