Growing old with asthma: what are the changes and challenges?

Abstract

Asthma is a disease that affects approximately 7% of adults residing in the USA; the prevalence is even greater in children and approaches 10%. The CDC has reported that the overall prevalence of lifetime asthma is 10.5%. New-onset asthma is most often seen in children and is associated with atopy; however, the majority of patients will experience a remission during adolescence. Many former asthmatics will have a reoccurrence of their disease in adulthood and asthma may persist thereafter for a lifetime. New-onset asthma may also begin later in life and remission is uncommon. The burden of asthma is therefore high in the geriatric population and healthcare utilization and mortality from asthma is excessive in this age group. There are many differences with asthma occurring in older adults when compared with younger asthmatics. This includes the frequency of medical comorbidities, the presence in many patients of fixed airflow obstruction that resembles chronic obstructive pulmonary disease, and the lack of perception of dyspnea that may delay effective medical care. Despite these and other differences, the pathophysiology and clinical presentation of asthma in the elderly is similar to that in younger asthmatics and attention to the unique features of aging can lead to improved outcomes in this age group.

Keywords::

• asthma
• asthma in the elderly
• atopy
• fixed airflow obstruction
• immunosenescence
• remodeling of airways

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.