Depression and Asthma Outcomes in Older Adults: Results from the National Health and Nutrition Examination Survey

Patel, Pooja; Patel, Minal R.; Baptist, Alan P.

doi:10.1016/j.jaip.2017.03.034

Cited by 45 publications

(29 citation statements)

References 26 publications

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“…Depression is an important asthma comorbidity and has been associated with worsening disease control in adults 45 , 46 . Plourde et al 47 validated the BDI, one of the most widely used questionnaires to screen depression in health research areas 24 , 47 – 50 , to be used in asthmatic adult patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Felix

Agondi

Aun

et al. 2021

Sci Rep

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This study aimed to evaluate the clinical evolution, functional parameters and inflammatory activity of asthma in patients who submitted to an educational intervention. 58 adult patients over 18 years of age with partly controlled and uncontrolled asthma were randomized into an intervention group (IG) (N = 32) and a control group (CG) (N = 26) and evaluated for 12 weeks. The Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ), Asthma Quality Life Questionnaire (AQLQ) and Beck Depression Inventory (BDI) questionnaires were applied. Spirometry, exhaled nitric oxide (NO), exhaled breath condensate (EBC) and induced sputum (IS), measurement of the peak flow and symptoms were performed. The IG patients received an educational activity for 30 min applied by a nurse. Statistical analysis: analysis of variance with repeated intragroup measures. IG presented a decreased number of eosinophils in IS and IL-17A in EBC, an increase in the percentage of FEV1 before and after bronchodilator and an improvement in quality of life compared to the CG. There was an improvement in depression levels and a decrease in IL-4 and IL-5 in the IS and in the EBC in both groups. Our results suggest that an educational intervention can bring benefits concerning the control of inflammation, lung function alterations, quality of life and levels of depression in asthmatic patients. Registration: ClinicalTrials.gov; NCT03655392.

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Section: Discussionmentioning

confidence: 99%

Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Felix

Agondi

Aun

et al. 2021

Sci Rep

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“…The high co-occurrence of psychiatric disease and asthma suggests there may be a link between an individual's psychologic health and asthma [119][120][121]. Now, it is increasingly understood that beyond psychiatric disease, certain psychosocial stressors may increase risk of or worsen asthma.…”

Section: Psychosocial Stress: Childhood Adversity and Community Violencementioning

confidence: 99%

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Sullivan

Thakur

2020

Curr Allergy Asthma Rep

122

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Purpose of Review Using the WHO Conceptual Framework for Action on the Social Determinants of Health, this review provides a discussion of recent epidemiologic, mechanistic, and intervention studies of structural and social determinants of health and asthma outcomes covering the period from 2014 to 2019. Recent Findings A majority of studies and interventions to date focus on the intermediary determinants of health (e.g., housing), which as the name suggests, exist between the patient and the upstream structural determinants of health (e.g., housing policy). Race/ethnicity remains a profound social driver of asthma disparities with cumulative risk from many overlapping determinants. A growing number of studies on asthma are beginning to elucidate the underlying mechanisms that connect social determinants to human disease. Several effective interventions have been developed, though a need for large-scale policy research and innovation remains. Summary Strong evidence supports the key role of the structural determinants, which generate social stratification and inequity, in the development and progression of asthma; yet, interventions in this realm are challenging to develop and therefore infrequent. Proximal, intermediary determinants have provided a natural starting point for interventions, though structural interventions have the most potential for major impact on asthma outcomes. Further research to investigate the interactive effect of multiple determinants, as well as intervention studies, specifically those that are cross-sector and propose innovative strategies to target structural determinants, are needed to address asthma morbidities, and more importantly, close the asthma disparity gap.

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“…55 A recent article in the Journal demonstrated that older adults with asthma and depression were nearly twice as likely to have poor asthma outcomes across several indicators, including asthma-related ED/urgent care visits, compared with those without depression. 56 The mechanisms responsible for depression worsening asthma outcomes are not clearly established, and may relate to inflammation, cerebral anatomic changes, autonomic nervous dysfunction, decreased adherence, or ineffective self-management behaviors. 57…”

Section: Unique Factors That Can Complicate Asthma Management Among Omentioning

confidence: 99%

Asthma Over the Age of 65: All's Well That Ends Well

Baptist

Busse

2018

The Journal of Allergy and Clinical Immunology: In Practice

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Asthma in older adults (often classified as those 65 years or older) is relatively common, underdiagnosed, and suboptimally treated. It is an important health problem, as the population of the United States continues to age. Unfortunately, asthma morbidity and mortality rates are highest in this age group. Alterations in the innate and adaptive immune responses occur with aging, and contribute to pathophysiologic differences and subsequent treatment challenges. The symptoms of asthma may differ from those in younger populations, and often include fatigue. There are unique factors that can complicate asthma management among older adults, including comorbidities, menopause, caregiver roles, and depression. Pharmacologic therapies are often not as effective as in younger populations, and may have greater side effects. Spirometry, peak flow measurements, and asthma education are typically underused, and may contribute to delays in diagnosis as well as worse outcomes. There are specific strategies that health care providers can take to improve the care of older adults with asthma.

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Depression and Asthma Outcomes in Older Adults: Results from the National Health and Nutrition Examination Survey

Cited by 45 publications

References 26 publications

Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Clinical, functional and inflammatory evaluation in asthmatic patients after a simple short-term educational program: a randomized trial

Structural and Social Determinants of Health in Asthma in Developed Economies: a Scoping Review of Literature Published Between 2014 and 2019

Asthma Over the Age of 65: All's Well That Ends Well

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