Chronic Bronchial Asthma in the Older Age Group

Unger, Leon

doi:10.1016/s0025-7125(16)34613-2

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…The degree of dyspnoea reported by the patients was unrelated to the duration of asthma in some studies [6,19]. However, in other studies [20,21], it was suggested that as people grow older they may adapt to the presence of symptoms. It is known that prolonged periods of stimulation result in a consistent reduction in perceived magnitude, a process known as temporal adaptation [22,23].…”

Section: Discussionmentioning

confidence: 88%

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Characteristics of asthma in the elderly

Weiner¹,

Magadle²,

Waizman³

et al. 1998

Eur Respir J

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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.

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Section: Discussionmentioning

confidence: 88%

“…Acute attacks of asthma in older people may be rapidly fatal and have poorer prognosis than in the young [28]. Both chronicity [21] and impaired awareness of bronchoconstriction [29] may lead to the higher mortality in older asthmatics.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of asthma in the elderly

Weiner¹,

Magadle²,

Waizman³

et al. 1998

Eur Respir J

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“…The mean awareness score in elderly normal subjects was lower (1-53 (0-17)) than in young normal subjects (2-76 (0 22); p = 0 004). Asthmatic subjects The mean percentage fall in FEV1 for asthmatic patients was 246 (1)(2)(3)(4)(5). Elderly asthmatic patients had somewhat greater percentage falls (mean 27-4 (2 2)) than young patients (21X5 (1-7); p < 0 001).…”

Section: Resultsmentioning

confidence: 97%

Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale.

Connolly¹,

Crowley²,

Charan³

et al. 1992

Thorax

242

137

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The death rate from asthma is highest in old age and continues to rise, despite diagnostic and therapeutic advances.'3 Acute attacks of asthma in older people with chronic asthma may be very rapidly fatal4 and have been said to have a poorer prognosis than in the young.5 Of the many potential reasons for the higher mortality from asthma in old age, the possibility of impaired awareness of the severity of an acute asthmatic attack by the elderly patient, his physician, or both has been little investigated. Petheram et al 6 showed that during acute exacerbations of asthma elderly patients have less pronounced pulsus paradoxus and tachycardia than younger patients with similar airway obstruction and blood gas abnormalities. They argued that this might theoretically result in undertreatment of the elderly asthmatic patient during an acute attack. Treatment might also be inadequate if the severity of the attack were also underestimated by the patient. This may indeed be the case in the elderly. Elderly asthmatic patients tend to deteriorate for longer periods at home before admission,6 and when challenged with inhaled methacholine they do not report dyspnoea or wheeze to be troublesome despite a minimum fall in one second expiratory volume (FEV,)

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“…When these patients develop acute life-threatening exacerbations they should be managed as vigorously as younger patients. The data show that Unger's previous gloomy prognosis for severe asthma in the elderly (Unger, 1956) may no longer be tenable.…”

Section: Discussionmentioning

confidence: 87%

“…Asthma developing later in life tends to produce chronic daily symptoms and often needs corticosteroids for optimum control. On a background of chronic respiratory symptoms these patients may also suffer sudden severe exacerbations which have been considered to have a poor prognosis (Unger, 1956) and may cause death as rapidly as in younger patients (McDonald, Seaton and Williams, 1976). The authors studied 20 patients aged 65 years or over, admitted consecutively, to find whether severe attacks differed clinically or by laboratory assessment from attacks in 87 patients aged 40 years or less, admitted during the same period, and to com-pare the response of airways obstruction of each group to an intensive regime of treatment.…”

Section: Introductionmentioning

confidence: 99%

Assessment and management of acute asthma in the elderly: a comparison with younger asthmatics

Petheram

Jones

Collins

1982

Postgraduate Medical Journal

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Assessment on admission and responses to treatment were studied in 20 patients aged 65 years or over admitted with severe acute exacerbations of asthma and were compared with patients aged 40 years or less who were managed similarly. The elderly asthmatic had less marked tachycardia and pulsus paradoxus compared to the younger group for similar degrees of airways obstruction and arterial blood gas abnormalities. Assessment confined to physical examination would, therefore, have underestimated the severity of their asthma. The rates of improvement in airflow obstruction were similar in both young and old but those elderly patients who had required maintenance oral corticosteroids were less likely to reach their predicted peak expiratory flow rate (PEFR) than their peers or younger patients.

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Chronic Bronchial Asthma in the Older Age Group

Cited by 3 publications

References 16 publications

Characteristics of asthma in the elderly

Characteristics of asthma in the elderly

Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale.

Assessment and management of acute asthma in the elderly: a comparison with younger asthmatics

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