Characteristics of asthma in the elderly

Abstract

Asthma occurs more frequently in the elderly than is usually appreciated and may, therefore, be underdiagnosed and undertreated. This study evaluated the relationship between asthma symptoms and the degree of airflow obstruction in elderly and young asthmatics. Fifteen young asthmatics (<65 yrs) (group A), 15 aged >65 yrs with onset of symptoms before 65 yrs (group B), and 15 aged >65 yrs with onset of symptoms after 65 yrs (group C), were studied. Patients used daily diary cards, during 2 weeks, to record inhaled beta2-agonist consumption and severity of asthma symptoms. Long-standing asthma was associated with a significantly lower forced expiratory volume in one second as compared with recent onset asthma. The asthma-symptom score was highest in group A, lower in group B and significantly lower in group C. When symptoms were related to the degree of obstruction (asthma index), it was higher in the young asthmatics than in both groups of elderly patients. In conclusion, elderly patients with long-standing asthma had more severe airway obstruction than patients with recently acquired disease. Older patients particularly those with long-standing disease complained less about asthma symptoms. Within the various groups of patients, subjective symptoms of asthma were negatively related to asthma duration.

Disease control in general practice patients with asthma

“…The finding that older age is associated with inadequate control of asthma, might be explained by the finding that older patients generally have a more blunted perception of their pulmonary obstruction [27][28][29]. In addition, Weiner et al [29] report that particularly older patients with long-standing disease had less pulmonary complaints irrespective of the level of pulmonary obstruction.…”

“…In addition, Weiner et al [29] report that particularly older patients with long-standing disease had less pulmonary complaints irrespective of the level of pulmonary obstruction. This supports our finding that a younger age at onset of pulmonary complaints is associated with inadequate control after adjusting for other variables such as age.…”

Asthma in young and elderly: The differences

“…The high prevalence of comorbidities in our study is similar to other studies. 3,6,9,12 Higher incidence of GERD can be because GERD is known to trigger exacerbation of bronchial asthma. Asthma can also lead on to GERD because of aerophagia, hyperinfl ation of lungs and anti asthma medications can cause relaxation of lower esophageal sphincter.…”

“…3,4,5,6 Although atopy was signifi cantly higher in younger asthmatics, but potential allergens should be avoided in both elderly and young asthmatics. 2,3 Although asthma in elderly may be a continuum of young age, 7,8 but in present study 84% patients had onset after age of 40 years.…”

Allergic Asthma and Aging

“…In elderly patients there is a close relationship between the severity of wheezing complaints and impairment of the forced expiratory volume in 1 second (FEV1). Elderly patients with longstanding asthma have more severe airway obstruction than patients with recently acquired disease but patients with newly diagnosed asthma experienced a more rapid rate of decline FEV1 than patients with chronic asthma [16,17].…”