High Prevalence of Asthma in Elderly Women: Findings From a Korean National Health Database and Adult Asthma Cohort

Abstract

PurposeThe prevalence and burden of asthma is increasing worldwide. In this study, we analyzed 3 different Korean national health survey datasets to determine the general features of adult asthma in Korea and to obtain basic information that would support future strategies for better management of adult asthma.MethodsThe surveys used in this study included the Korea National Health and Nutrition Examination Survey (KNHANES), Korea Community Health Survey (KCHS) and National Health Insurance Service-National Sample Cohort (NHIS-NSC). We investigated annual asthma prevalence, evaluating the rate and risk factors of asthma exacerbation by age and sex, and clinical data of 1,832 patients with asthma who were registered in the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) were analyzed to elucidate risk factors for asthma exacerbation. We also analyzed another asthma cohort and added it as replication data.ResultsIn the KNHANES database, annual asthma prevalence rates varied from 1.2% to 3.1%. In the KCHS database, overall prevalence increased, with significant regional differences (1.6%–2.1%). The NHIS-NSC indicated a gradual increase in annual asthma prevalence from 4.5% to 6.2%. Interestingly, all 3 surveys indicated the highest prevalence of asthma among elderly women. In addition, elderly women with asthma had a significantly higher risk of asthma exacerbation (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.19–2.93; P=0.006). Approximately 11% of patients were classified as having severe asthma. An asthma cohort analysis identified female sex, low baseline pulmonary function, longer treatment duration, high variability in pulmonary function and significant changes in Asthma Control Test scores as risk factors for asthma exacerbation.ConclusionsThe prevalence of asthma in Korea is consistently high among elderly and female populations. These results should lay the foundation for strategies for effective asthma prevention and management; elderly female patients with asthma should receive particular attention.

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“…Large-scale epidemiological data that can be used to investigate the prevalence of diseases in Korea can be obtained from the National Health Insurance Service-National Sample Cohort (NHIS-NSC) in addition to KNHANES, and the asthma prevalence in Korea, which is generally investigated by the NHIS-NSC, tends to be higher than in KNHANES. 18 However, it was determined that KNHANES was more suitable than the NHIS-NSC because the criteria for physician-diagnosed asthma were more consistent with KNHANES standards, and the unique health insurance system in Korea can affect the prevalence rates of the NHIS-NSC. In most age groups, there was no significant difference from the general population, but the prevalence of asthma in the 19-29 year age group was less than that of KNHANES.…”

“…KNHANES reports the results every year as a nationwide cross-sectional survey, which has been maintained by the KCDC since 1998. 17,18 In this study, KNHANES data according to the total population, age, and gender, which were corrected according to the demographic structure from 2015 to 2018, was used.…”

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“…The global prevalence of asthma was reported to be 4.3% to 8.6% in the adult population . In a Korean population, a prevalence of adult asthma of approximately 4.5% to 6.2% was reported . In addition, the prevalence of asthma in children was approximately 6.27% to 7.39% in a Korean population .…”

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“…25 This link of air pollution, the incidence of asthma and increased risk of exacerbations have been demonstrated in studies from China, 26 Hong Kong, 27 Taiwan 28,29 and South Korea. 30 While cities such as New Delhi and Beijing have been worst hit by air pollution, several government-led programmes have attempted to address the issue of air pollution.…”