Asthma in the elderly: what we know and what we have yet to know

Abstract

In the past, asthma was considered mainly as a childhood disease. However, asthma is an important cause of morbidity and mortality in the elderly nowadays. In addition, the burden of asthma is more significant in the elderly than in their younger counterparts, particularly with regard to mortality, hospitalization, medical costs or health-related quality of life. Nevertheless, asthma in the elderly is still been underdiagnosed and undertreated. Therefore, it is an imperative task to recognize our current challenges and to set future directions. This project aims to review the current literature and identify unmet needs in the fields of research and practice for asthma in the elderly. This will enable us to find new research directions, propose new therapeutic strategies, and ultimately improve outcomes for elderly people with asthma. There are data to suggest that asthma in older adults is phenotypically different from young patients, with potential impact on the diagnosis, assessment and management in this population. The diagnosis of AIE in older populations relies on the same clinical findings and diagnostic tests used in younger populations, but the interpretation of the clinical data is more difficult. The challenge today is to encourage new research in AIE but to use the existing knowledge we have to make the diagnosis of AIE, educate the patient, develop a therapeutic approach to control the disease, and ultimately provide a better quality of life to our elderly patients.

Effects of omalizumab in severe asthmatics across ages: A real life Italian experience

“…Furthermore, comorbidities are associated with an ageing population; they negatively affect health outcomes and are associated with asthma in these subjects (8)(9)(10). In fact, according to our study, comorbidities such as hypertension, chronic heart disease, diabetes, gastro-esophageal reflux and osteoporosis are more prevalent in old age, making the disease more severe thus influencing the reduced response to treatment with Omalizumab in the elderly.…”

“…In fact, the elderly have lower post-bronchodilator FEV 1 %, more exacerbations and risk of first severe exacerbation is increased by 55.3% when compared to younger patients (7). Asthma in the elderly seems to represent a specific phenotype characterized by more severe, but often less perceived, airway obstruction, a neutrophilic or mixed-type of airway inflammation and frequent comorbidities (8,9).…”

“…Older patients with asthma have significantly increased percentages of sputum neutrophils (12). This pattern is a characteristic of intrinsic asthma with neutrophilic inflammation that may be associated to a more severe obstructive disease and a poor response to treatment (8)(9)(10). In addition, elderly subjects usually have multiple chronic illnesses that can be also associated with poor asthma outcomes (13)(14)(15).…”

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.…”

Study of Psychosocial Factors in Young and Elderly Asthmatics

“…1 Over past few decades, average life expectancy has increased significantly, globally, as well as in India. 2,3,4 Dealing with the burden of the disease becomes more important in the elderly because of associated increased mortality, hospitalizations, medical costs and health related quality of life.…”