Asthma in the Elderly Patient

Jack, Cia; Lye, Michael

doi:10.1159/000213774

Cited by 20 publications

(9 citation statements)

References 16 publications

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“…Asthma is common in old age and carries significant morbidity and mortality (1,2). Incontrovertible evidence exists that there is a progressive and strikingly increased mortality from bronchial asthma (3).…”

Section: Introductionmentioning

confidence: 99%

Perception of Bronchoconstriction in Elderly Asthmatics

et al. 2001

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The impaired perception of bronchoconstriction in asthmatic patients may increase the risk of severe exacerbation. To characterize the perception of bronchoconstriction in elderly asthma patients, we compared the perception in older patients with that of younger patients. To determine the influence of perception of long-standing diseases, we further evaluated the perception in early-onset elderly asthma patients and in late-onset elderly asthma patients. The study group consisted of 80 stable asthmatic patients. The patients were grouped according to their age (group 1, < 60 years, n = 37, group 2, > or = 60 years, n = 43). Each group was separated into two subgroups according to the duration of symptoms (late-onset asthma 1A and 2A, < 5 years, early-onset asthma 1B and 2B, > or = 5 years). A histamine inhalation test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in forced expiratory volume in 1 sec (FEV1) reduction by 20% was determined as perception score 20 (PS20). The mean perception scores of the elderly asthmatic patients were significantly lower than those of the younger asthmatic patients (group 1, PS20 = 2.35 +/- 0.17; group 2, PS20 = 1.37 +/- 0.12, p < 0.0001). The differences of mean perception score (PS20) between early- and late-onset subgroups were insignificant (IA, 2.63 +/- 0.30 and IB, 2.07 +/- 0.16, p = 0.101; 2A, 1.36 +/- 0.19 and 2B, 1.59 +/- 0.120, p = 0.91). The mean perception scores of male asthmatic patients were significantly lower than those of female patients (p = 0.03). There was a correlation between PS20 and % FEV1 in the younger group (r = 0.392, p = 0.02), but not in the elderly group (r = 139, p = 0.375). The correlation between PS20 and PD20 in both younger and elderly group was insignificant (p > 0.05). Elderly asthmatics perceive less intense respiratory distress for a decrease of 20% in FEV1 than do younger asthmatics. This underperception of bronchoconstriction may result in a delay in medical care during an acute asthmatic episode. Thus, we strongly recommend that elderly asthmatic patients should be followed up more frequently and closely.

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Section: Introductionmentioning

confidence: 99%

Perception of Bronchoconstriction in Elderly Asthmatics

et al. 2001

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“…Peak expiratory flow rates are more difficult to obtain in older people, 6 and the flow rates are sometimes too low to measure change accurately. Office spirometry, while not necessarily easier to perform, measures FEV 1 , which has a better range for measuring change.…”

Section: What We Need To Domentioning

confidence: 99%

How is the diagnosis of asthma in older people established in clinical practice?

Yates

2005

Medical Journal of Australia

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What we need to know How is breathlessness perceived and defined in older people? What impact does breathlessness have on quality of life? Can history taking and physical examination be tailored to efficiently cover all the organ systems associated with breathlessness? Can a self‐ or carer‐rated questionnaire be used to identify asthma in patients with breathlessness? What we need to do Develop self‐ and carer‐rated questionnaires that measure change in function and quality of life before and after treatment. Validate objective measures of physical function and airflow that are sufficiently sensitive to measure change with treatment. Develop a diagnostic guideline in general practice that includes measures of mood and cognitive function and involves carers where necessary. Provide rehabilitation and restorative care services.

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“…Asthma may disappear with time in up to 50% of asthmatic children [2] but at the same time it may develop in up to 10% at 33 years in subjects who had no evidence of asthma at the age of 7 years [3]. In elderly subjects, asthma may actually be quite frequent, and the great majority of all asthma deaths occur after the age of 60 [7]. New‐onset asthma may occur after the age of 65 with an annual incidence 60–100/100,000, which is no different from the incidence in young and middle age adults [4].…”

Section: Late‐onset Asthmamentioning

confidence: 99%

What can we learn from late‐onset and occupational asthma?

Papi

Corbetta

Fabbri

1998

Clin Experimental Allergy

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Late-onset asthma and occupational asthma may provide interesting models of human asthma to compare with the most frequent type of atopic early-onset asthma. The discovery of similarities and discrepancies in the aetiology and pathogenesis of these different diseases might provide new insights on different mechanisms producing the same phenotype and, thus, by recognizing the different underlying mechanisms of the different forms of asthma, may allow better targeting of prevention and treatment. Occupational asthma, in addition to being a late-onset asthma, provides the unique opportunity to study the development of asthma under measurable exposure conditions, and consequently to examine the effect of cessation of exposure which, at variance with allergen avoidance, is possible in most of the cases.

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Asthma in the Elderly Patient

Cited by 20 publications

References 16 publications

Perception of Bronchoconstriction in Elderly Asthmatics

Perception of Bronchoconstriction in Elderly Asthmatics

How is the diagnosis of asthma in older people established in clinical practice?

What can we learn from late‐onset and occupational asthma?

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