Is Asthma in the Elderly Really Different?

Quadrelli, Sílvia; Aj, Roncoroni

doi:10.1159/000029294

Cited by 41 publications

(37 citation statements)

References 20 publications

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“…In symptomatic asthma in the elderly population, we have found that the most frequent subgroup is ‘severe’ (55% of patients), while in adults mild asthma was the most common (47%). In agreement with our results, Quadrelli and Roncoroni [24]observed a lesser proportion of patients with only mild symptoms in patients older than 65 compared with those younger than 40 years, suggesting that the duration of disease is a main factor influencing severity of asthma and development of irreversible airflow obstruction. The decrease observed in the FEV 1 among elderly asthmatics found in our study (59%) is in the range of figures reported in by other authors (between 49.5 and 67.5%) [10, 11].…”

Section: Discussionsupporting

confidence: 93%

Quality of Life and Economic Features in Elderly Asthmatics

Plaza

Serra-Batllés²,

Ferrer³

et al. 2000

Respiration

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Background: In the geriatric population, asthma tends to be overlooked. Moreover, typical symptoms of asthma may mimic chronic bronchitis and emphysema. Objective: To compare the characteristics of asthma between elderly (≥65 years) and adult (<65 years) asthma patients with regard to asthma severity, health-related quality of life, and direct expenditures for medical care generated by the disease. Methods: A cross-sectional study was made in the asthmatic population older than 14 years in the area of Barcelona, Spain. Asthma severity was determined according to the International Consensus criteria of 1992. St. George’s Respiratory Questionnaire (SGRQ) was used to measure the quality of life. Direct costs were calculated registering all costs generated by each patient per year. Results: The study population consisted of 282 adult asthmatics and 51 elderly asthmatics. Asthma was more severe in the elderly group (mild 10%, moderate 35%, severe 55%) than in the adult group (mild 47%, moderate 35%, severe 18%). Elderly asthmatics had significantly higher total SGRQ scores (48 vs. 35, p < 0.001) than adult asthmatics, as well as significantly higher scores for all subscales. Asthma-derived direct costs in elderly asthmatics (mean USD 1,490 vs. USD 773) were double those in adult asthmatics, mainly due to higher costs of hospitalization and medication in the elderly. Conclusions: Asthma in elderly people as compared with asthma in adulthood was more severe and was associated with a worse health-related quality of life, and significantly higher expenditures for medical care.

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Section: Discussionsupporting

confidence: 93%

Quality of Life and Economic Features in Elderly Asthmatics

Plaza

Serra-Batllés²,

Ferrer³

et al. 2000

Respiration

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“…Whether age predicts outcomes of asthma control has not yet been established. Previous epidemiologic surveys were not conclusive due to their retrospective design and imbalances in treatment [15,18,19,20]. The aim of our study is to evaluate whether age is associated with outcomes of asthma control in a prospective cohort of subjects receiving proper treatment.…”

Section: Introductionmentioning

confidence: 99%

Age Is Not Associated with Hospital Admission or Uncontrolled Symptoms of Asthma if Proper Treatment Is Offered

Ponte

Stelmach

Franco

et al. 2014

Int Arch Allergy Immunol

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Background: Aging modifies immune response and respiratory physiology. Few studies evaluate the effect of age on asthma. The aim of our study was to evaluate whether age is associated with uncontrolled symptoms and hospital admissions due to asthma in a setting where patients were receiving proper treatment. Methods: We enrolled 401 patients with uncontrolled asthma who were inhaled corticosteroid-naive. The follow-up period was 1 year. They received medications for asthma, performed spirometry, a symptoms questionnaire, and all emergency room visits and hospital admissions due to asthma were reported. The primary end point was hospital admission during the follow-up period. Results: Baseline data demonstrated that subjects >55 years of age had a later onset of asthma and a longer duration of symptoms. Adjusted logistic regression models demonstrated that older age at enrollment did not predict asthma control in the follow-up: hospital admission due to asthma [odds ratio (OR) 1.7 and 95% confidence interval (CI) 0.6-4.7], symptoms score (OR 0.6 and 95% CI 0.3-1.1) and emergency room visits due to asthma (OR 0.9 and 95% CI 0.6-1.3). Older age was associated with worse lung function (OR 1.8 and 95% CI 1.1-3.3). Conclusion: This study allows us to conclude that older age is associated with a later onset of asthma and a longer duration of symptoms. Age does not predict hospital admissions or poor control of asthma symptoms if proper treatment is offered. It does, however, predict worse lung function.

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“…'nın [19] bir çalışmasında 149 hasta ile yaptıkları çalışmada atopik hastalıkların her iki yaş grubunda (65 yaş altı 99, 65 yaş ve üstü 50 hasta) benzer oranda görül-düğünü; buna karşın eozinofili ve IgE düzeyinin yaşlı hastalarda daha düşük olduğunu tespit etmişlerdir. Bu durum ilerleyen yaşla birlikte alerjik yanıtın azalmasıyla ilişkili olabilir [20].…”

Section: Discussionunclassified

The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks

Dogru¹,

Kanat²,

Özer³

et al. 2013

Tur Toraks Der

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AMAÇ:Astım atağı nedeniyle yatırılarak tedavi edilen hastaların çeşitli risk faktörlerinin yaş gruplarına göre atak ağırlığındaki belirleyiciliği ve ilişkisi araştırıldı. GereÇ Ve yönteMler:Astım atağı tanısıyla hastaneye yatı-rılan 80 hasta çalışmaya dâhil edildi. Olgular 65 yaş altı (n=36; 52,5±7,6) ve üstü (n=44; 72,5±5,2) olmak üzere 2 gruba ayrılarak değerlendirildi. Hastaların demografik özellikleri, astım başlangıç yaşı ve astım süresi, astım ağırlık derecesi, atak şiddeti, atopi, atopik hastalıklar, ilaç ve besin alerjisi, ek hastalıklar, son 1 ay ve 3 ay içindeki tedavi durumu, atak nedeni, yatış süresi, astım nedeniyle son 1 yıl içinde acil servis ve hastaneye yatış sayısı, astım nedeniyle yaşamı boyunca toplam hastaneye yatış sayısı kaydedildi. Hastaların yatış ve çıkışta solunum fonksiyon testleri ve arter kan gazları alındı.BUlGUlAr: Altmış beş yaş üstü hastalarda osteoporoz varlığı, küf mantarı için cilt testi pozitifliği, son 1 aydaki teofilin kullanımının atak ağırlığını artırdığı tespit edildi. 65 yaş üstünde astım ağırlığın-dan bağımsız olarak atak şiddetinin daha ağır olduğu tespit edildi. Son 1 ay ve son 3 ayda her iki yaş grubundaki hastaların düzensiz tedavi aldığı belirlendi. sonUÇ: Yaşlı astım hastalarında teofilin kullanımı, küf mantarı duyarlılığı, biomas maruziyeti gelecekteki astım ataklarını önle-mek için daha dikkatli sorgulanmalı ve rehberler doğrultusunda gerekli koruyucu önlemler önerilmelidir.AnAhtAr sözcüKler: Astım, alevlenme, ileri yaş, hastaneye yatış, risk faktörleri oBJectIVe: The characteristics of patients hospitalised for an asthma attack were evaluated to delineate the impact of age on sensitivity to risk factors for this condition. MAterIAl And Methods:Eighty patients hospitalised for an asthma attack were included in this cross-sectional study. Patients were divided into two age groups; younger than 65-years-old (52.5±7.6 years, n=36) and older than 65-years-old (72.5±5.2 years, n=44). A questionnaire was used to collect data on demographics, initial age and duration of asthma, atopy, atopic diseases, drug and food allergies, additional diseases, treatments during the previous 1 and 3 months, cause of attacks, duration of hospital stay, number of emergency visits and hospitalisation due to asthma over the last year, and all past hospital stays. Pulmonary function tests were performed upon admittance and discharge, and parameters of arterial blood gases were recorded. resUlts:The severity of asthma attacks was greater in the older cohort of patients with risk factors including osteoporosis, positive skin test for mould, or theophylline use in the previous month. Independent of these variables, the severity of attacks was greater in patients over the age of 65. Irregular treatments in both age groups were noted over the previous one and three months.conclUsIon: Theophylline use, mould sensitivity and biomass exposure in elderly patients with asthma should be questioned more carefully and protective measures taken to avoid these risks in keeping with the recommended gui...

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Is Asthma in the Elderly Really Different?

Cited by 41 publications

References 20 publications

Quality of Life and Economic Features in Elderly Asthmatics

Quality of Life and Economic Features in Elderly Asthmatics

Age Is Not Associated with Hospital Admission or Uncontrolled Symptoms of Asthma if Proper Treatment Is Offered

The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks

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