Asthma Care in the Elderly: Practical Guidance and Challenges for Clinical Management - A Framework of 5 “Ps”

References

• Tan LD, Nguyen N, Alismail A, Castro M. Management of uncontrolled asthma: a framework for novel and legacy biologic treatments. J Asthma Allergy. 2022;29(15):875–883. doi:10.2147/JAA.S369836
   Google Scholar
• Skloot GS, Busse PJ, Braman SS, et al.; ATS ad hoc Committee on Asthma in the Elderly. An official American Thoracic Society workshop report: evaluation and management of asthma in the elderly. Ann Am Thorac Soc. 2016;13(11):2064–2077. doi:10.1513/AnnalsATS.201608-658ST
   PubMed Web of Science ®Google Scholar
• Ben-Harush A, Shiovitz-Ezra S, Doron I, et al. Ageism among physicians, nurses, and social workers: findings from a qualitative study. Eur J Ageing. 2016;14(1):39–48. doi:10.1007/s10433-016-0389-9
   PubMed Web of Science ®Google Scholar
• Salomon JA. Quality adjusted life years. In: Quah SR, editor. International Encyclopedia of Public Health (Second Edition). Academic Press; 2017:224–228.
   Google Scholar
• Yaghoubi M, Adibi A, Safari A, FitzGerald JM, Sadatsafavi M. The projected economic and health burden of uncontrolled asthma in the United States. Am J Respir Crit Care Med. 2019;200(9):1102–1112. doi:10.1164/rccm.201901-0016OC
   PubMed Web of Science ®Google Scholar
• Tsuchiya A. QALYs and ageism: philosophical theories and age weighting. Health Econ. 2000;9(1):57–68. doi:10.1002/(SICI)1099-1050(200001)9:1<57::AID-HEC484>3.0.CO;2-N
   PubMed Web of Science ®Google Scholar
• Kaur BP, Lahewala S, Arora S, et al. Asthma: hospitalization trends and predictors of in-hospital mortality and hospitalization Costs in the USA (2001-2010). Int Arch Allergy Immunol. 2015;168(2):71–78. doi:10.1159/000441687
   PubMed Web of Science ®Google Scholar
• Hanania NA, King MJ, Braman SS. Asthma in elderly workshop participants. Asthma in the elderly: current understanding and future research needs--a report of a National Institute on Aging (NIA) workshop. J Allergy Clin Immunol. 2011;128(3 Suppl):S4–24. doi:10.1016/j.jaci.2011.06.048
   PubMed Web of Science ®Google Scholar
• Oraka E, Kim HJ, King ME, Callahan DB. Asthma prevalence among US elderly by age groups: age still matters. J Asthma. 2012;49(6):593–599. doi:10.3109/02770903.2012.684252
   PubMed Web of Science ®Google Scholar
• Zhang Y, Huang L. Characteristics of older adult hospitalized patients with bronchial asthma: a retrospective study. Allergy Asthma Clin Immunol. 2021;17(1):122. doi:10.1186/s13223-021-00628-0
   PubMed Web of Science ®Google Scholar
• Tsai C, Lee W, Hanania NA. Age-Related differences in clinical outcomes for acute asthma in the United States, 2006-2008. J Allergy Clin Immunol. 2012;129:1252–1258.e1. doi:10.1016/j.jaci.2012.01.061
   PubMed Web of Science ®Google Scholar
• Safiri S, Karamzad N, Kaufman JS, et al. Prevalence, Deaths and Disability-Adjusted-Life-Years (DALYs) Due to Type 2 Diabetes and Its Attributable Risk Factors in 204 Countries and Territories, 1990-2019: results From the Global Burden of Disease Study 2019. Front Endocrinol. 2022;13:838027. doi:10.3389/fendo.2022.838027
   PubMed Web of Science ®Google Scholar
• Dunn RM, Busse PJ, Wechsler ME. Asthma in the elderly and late-onset adult asthma. Allergy. 2018;73(2):284–294. doi:10.1111/all.13258
   PubMed Web of Science ®Google Scholar
• Boulet LP, Robitaille C, Deschesnes F, Villeneuve H, Boulay MÈ. Comparative clinical, physiological, and inflammatory characteristics of elderly subjects with or without asthma and young subjects with asthma. Chest. 2017;152(6):1203–1213. doi:10.1016/j.chest.2017.09.019
   PubMed Web of Science ®Google Scholar
• Malenfant JH, Batsis JA. Obesity in the geriatric population - a global health perspective. J Glob Health Rep. 2019;3:e2019045. doi:10.29392/joghr.3.e2019045
   PubMedGoogle Scholar
• Wardzyńska A, Pawełczyk M, Rywaniak J, Makowska J, Jamroz-Brzeska J, Kowalski ML. Circulating miRNA expression in asthmatics is age-related and associated with clinical asthma parameters, respiratory function and systemic inflammation. Respir Res. 2021;22(1):177. doi:10.1186/s12931-021-01769-x
   PubMed Web of Science ®Google Scholar
• Gibson PG, Simpson JL. The overlap syndrome of asthma and COPD: what are its features and how important is it?”. Thorax. 2009;64:728–735. doi:10.1136/thx.2008.108027
   PubMed Web of Science ®Google Scholar
• Gherasim A, Dao A, Bernstein JA. Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy. World Allergy Organ J. 2018;11(29):29. doi:10.1186/s40413-018-0207-2
   PubMedGoogle Scholar
• Maykut RJ, Kianifard F, Geba GP. Response of older patients with IgE-mediated asthma to omalizumab: a pooled analysis. J Asthma. 2008;45(3):173–181. doi:10.1080/02770900701247277
   PubMed Web of Science ®Google Scholar
• Israel E, Reddel HK. Severe and difficult-to-treat asthma in adults. N Eng J Med. 2017;377:965–976. doi:10.1056/NEJMra1608969
   PubMed Web of Science ®Google Scholar
• Schleich F, Graff S, Guissard F, et al. Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping. Respir Res. 2021;22(1):15. doi:10.1186/s12931-021-01619-w
   PubMed Web of Science ®Google Scholar
• Incalzi RA, Bellia V, Catalano F, et al. Evaluation of health outcomes in elderly patients with asthma and COPD using disease-specific and generic instruments: the salute respiratoria nell’Anziano. Chest. 2001;120(3):734–742. doi:10.1378/chest.120.3.734
   PubMed Web of Science ®Google Scholar
• Battaglia S, Benfante A, Spatafora M, Scichilone N. Asthma in the elderly: a different disease? Breathe. 2016;12(1):18–28. doi:10.1183/20734735.002816
   Google Scholar
• Khatri SB, Iaccarino JM, Barochia A, et al.; American Thoracic Society Assembly on Allergy, Immunology, and Inflammation. Use of fractional exhaled nitric oxide to guide the treatment of asthma: an official American Thoracic Society Clinical Practice Guideline. Am J Respir Crit Care Med. 2021;204(10):e97–e109. doi:10.1164/rccm.202109-2093ST
   PubMed Web of Science ®Google Scholar
• Agondi RC, Andrade MC, Takejima P, Aun MV, Kalil J, Giavina-Bianchi P. Atopy is associated with age at asthma onset in elderly patients. J Allergy Clin Immunol Pract. 2018;6(3):865–871. doi:10.1016/j.jaip.2017.10.028
   PubMed Web of Science ®Google Scholar
• Cuttitta G, Cibella F, Bellia V, et al. Changes in FVC during methacholine-induced bronchoconstriction in elderly patients with asthma: bronchial hyperresponsiveness and aging. Chest. 2001;119(6):1685–1690. doi:10.1378/chest.119.6.1685
   PubMed Web of Science ®Google Scholar
• Sears MR. Lung function decline in asthma. Eur Resp J. 2007;30(3):411–413. doi:10.1183/09031936.00080007
   PubMed Web of Science ®Google Scholar
• Yawn BP, Han MK. Practical considerations for the diagnosis and management of asthma in older Adults. Mayo Clin Proc. 2017;92(11):1697–1705. doi:10.1016/j.mayocp.2017.08.005
   PubMed Web of Science ®Google Scholar
• Lowery EM, Brubaker AL, Kuhlmann E, Kovacs EJ. The aging lung. Clin Interv Aging. 2013;8:1489–1496. doi:10.2147/CIA.S51152
   PubMed Web of Science ®Google Scholar
• Proença de Oliveira-Maul J, Barbosa de Carvalho H, Goto DM. Aging, diabetes, and hypertension are associated with decreased nasal mucociliary clearance. Chest. 2013;143(4):1091–1097. doi:10.1378/chest.12-1183
   PubMed Web of Science ®Google Scholar
• Cortes T, Lee A, Boal J, Mion L, Butler A. Using focus groups to identify asthma care and education issues for elderly urban-dwelling minority individuals. Appl Nurs Res. 2004;17(3):207–212. doi:10.1016/j.apnr.2004.06.002
   PubMed Web of Science ®Google Scholar
• Enright PL, McClelland RL, Newman AB, Gottlieb DJ, Lebowitz MD. Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group. Chest. 1999;116(3):603–613. doi:10.1378/chest.116.3.603
   PubMed Web of Science ®Google Scholar
• Federman AD, O’Conor R, Mindlis I, et al. Effect of a self-management support intervention on asthma outcomes in older adults: the SAMBA Study Randomized Clinical Trial. JAMA Intern Med. 2019;179(8):1113–1121. doi:10.1001/jamainternmed.2019.1201
   PubMed Web of Science ®Google Scholar
• Allen SC, Baxter M. A comparison of four tests of cognition as predictors of inability to perform spirometry in old age. Age Ageing. 2009;38(5):537–541. doi:10.1093/ageing/afp104
   PubMed Web of Science ®Google Scholar
• Ruppel GL, Enright PL. Pulmonary function testing. Respir Care. 2012;57(1):165–175. doi:10.4187/respcare.01640
   PubMed Web of Science ®Google Scholar
• Baptist AP, Busse PJ. Asthma over the age of 65: all’s well that ends well. J Allergy Clin Immunol Pract. 2018;6(3):764–773. doi:10.1016/j.jaip.2018.02.007
   PubMed Web of Science ®Google Scholar
• Ruessel K, Luecke E, Schreiber J. Inhaler devices in a geriatric patient population: a prospective cross-sectional study on patient preferences. Patient Prefer Adherence. 2020;7(14):1811–1822. doi:10.2147/PPA.S262057
   Google Scholar
• Battaglia S, Cardillo I, Lavorini F, Spatafora M, Scichilone N. Safety considerations of inhaled corticosteroids in the elderly. Drugs Aging. 2014;31(11):787–796. doi:10.1007/s40266-014-0213-1
   PubMed Web of Science ®Google Scholar
• Sin DD, Tu JV. Underuse of inhaled steroid therapy in elderly patients with asthma. Chest. 2001;119(3):720–725. doi:10.1378/chest.119.3.720
   PubMed Web of Science ®Google Scholar
• Scichilone N, Ventura MT, Bonini M, et al. Choosing wisely: practical considerations on treatment efficacy and safety of asthma in the elderly. Clin Mol Allergy. 2015;13(7). doi:10.1186/s12948-015-0016-x
   PubMedGoogle Scholar
• Chapman KR, Barnes NC, Greening AP, Jones PW, Pedersen S. Single maintenance and reliever therapy (SMART) of asthma: a critical appraisal. Thorax. 2010;65(8):747–752. doi:10.1136/thx.2009.128504
   PubMed Web of Science ®Google Scholar
• Beasley R, Harrison T, Peterson S, et al. Evaluation of budesonide-formoterol for maintenance and reliever therapy among patients with poorly controlled asthma: a systematic review and meta-analysis. JAMA Netw Open. 2022;5(3):e220615. doi:10.1001/jamanetworkopen.2022.0615
   PubMed Web of Science ®Google Scholar
• 2020 Focused updates to the asthma management guidelines: a report from the national asthma education and prevention program coordinating committee expert panel working group. National Heart Lung and Blood Institute, US Department of Health and Human Services; 2020. Available from: https://www.nhlbi.nih.gov/resources/2020-focused-updates-asthma-management-guidelines. Accessed December 23, 2022.
   Google Scholar
• Balkrishnan R, Christensen DB, Bowton DL. Self-reported health status, prophylactic medication use, and healthcare costs in older adults with asthma. J Am Geriatr Soc. 2002;50(5):924–929. doi:10.1046/j.1532-5415.2002.50221.x
   PubMed Web of Science ®Google Scholar
• Global Initiative for Asthma. Global Strategy for Asthma Management andPrevention; 2022. Available from: www.ginasthma.org. Accessed December 23, 2022.
   Google Scholar
• Maricoto T, Marques-Gomes J, Correia-de-Sousa J, Taborda-Barata L. Inhaler review in older adults with asthma or COPD: a cost-effectiveness study and a perspective in Portugal. J Am Geriatr Soc. 2019;67(7):1430–1436. doi:10.1111/jgs.15834
   PubMed Web of Science ®Google Scholar
• Zampogna E, Paneroni M, Cherubino F, et al. Effectiveness of a pulmonary rehabilitation program on persistent asthma stratified for severity. Respir Care. 2019;64(12):1523–1530. doi:10.4187/respcare.06761
   PubMed Web of Science ®Google Scholar
• Borda MG, Celis-Preciado CA, Pérez-Zepeda MU, Ríos-Zuluaga JD. Cano-Gutiérrez CA Sarcopenia in the elderly with history of COPD/Asthma. Results of the SABE-Bogotá Study. Rev Esp Geriatr Gerontol. 2017;52(6):313–316. doi:10.1016/j.regg.2016.07.003
   PubMedGoogle Scholar
• Nanda A, Baptist AP, Divekar R, et al. Asthma in the older adult. J Asthma. 2020;57(3):241–252. doi:10.1080/02770903.2019.1565828
   PubMed Web of Science ®Google Scholar
• Sohn KH, Song WJ, Park JS, et al.; Elderly Asthma Cohort in Korea Group. Risk factors for acute exacerbations in elderly asthma: what makes asthma in older adults distinctive? Allergy Asthma Immunol Res. 2020;12(3):443–453. doi:10.4168/aair.2020.12.3.443
   PubMed Web of Science ®Google Scholar
• Johnston SL, Pattemore PK, Sanderson G, et al. Community study of role of viral infections in exacerbations of asthma in 9-11 year old children. BMJ. 1995;310(6989):1225–1229. doi:10.1136/bmj.310.6989.1225
   PubMed Web of Science ®Google Scholar
• Nicholson KG, Kent J, Ireland DC. Respiratory viruses and exacerbations of asthma in adults. BMJ. 1993;307(6910):982–986. doi:10.1136/bmj.307.6910.982
   PubMed Web of Science ®Google Scholar
• Normansell R, Sayer B, Waterson S, Dennett EJ, Del Forno M, Dunleavy A. Antibiotics for exacerbations of asthma. Cochrane Database Syst Rev. 2018;6(6):CD002741. doi:10.1002/14651858.CD002741.pub2
   PubMedGoogle Scholar
• Singh AM, Busse WW. Asthma exacerbations. 2: aetiology. Thorax. 2006;61(9):809–816. doi:10.1136/thx.2005.045179
   PubMed Web of Science ®Google Scholar
• Busse WW, Lemanske RF, Gern JE. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet. 2010;376(9743):826–834. doi:10.1016/S0140-6736(10)61380-3
   PubMed Web of Science ®Google Scholar
• Lugogo N, Judson E, Haight E, et al. Severe asthma exacerbation rates are increased among female, Black, Hispanic, and younger adult patients: results from the US CHRONICLE study. J Asthma. 2022;9:1–14. doi:10.1080/02770903.2022.2102036
   Google Scholar
• Menzies-Gow AN, McBrien C, Unni B, et al. Real world biologic use and switch patterns in severe asthma: data from the international severe asthma registry and the US CHRONICLE study. J Asthma Allergy. 2022;13(15):63–78. doi:10.2147/JAA.S328653
   Google Scholar
• Watson L, Turk F, James P, et al. Factors associated with mortality after an asthma admission: a national United Kingdom database analysis. Respir Med. 2007;101(8):1659–1664. doi:10.1016/j.rmed.2007.03.006
   PubMed Web of Science ®Google Scholar
• Louie S. The perils of prednisone. Consultant. 2020;60(9):12–16. doi:10.25270/con.2020.09.00001
   Google Scholar
• Newnham DM. Asthma medications and their potential adverse effects in the elderly: recommendations for prescribing. Drug Saf. 2001;24(14):1065–1080. doi:10.2165/00002018-200124140-00005
   PubMed Web of Science ®Google Scholar
• Figueiredo RG, Pinheiro GP, Arata V, et al. Impact of frailty in elderly patients with moderate to severe asthma. PLoS One. 2022;17(7):e0270921. doi:10.1371/journal.pone.0270921
   PubMed Web of Science ®Google Scholar
• Brooks TL, Leventhal H, Wolf MS, et al. Federman AD Strategies used by older adults with asthma for adherence to inhaled corticosteroids. J Gen Intern Med. 2014;29(11):1506–1512. doi:10.1007/s11606-014-2940-8
   PubMed Web of Science ®Google Scholar
• Hoyte FCL, Mosnaim GS, Rogers L, et al. Effectiveness of a digital inhaler system for patients with asthma: a 12-week, open-label, randomized study (CONNECT1). J Allergy Clin Immunol Pract. 2022;10(10):2579–2587. doi:10.1016/j.jaip.2022.08.023
   PubMed Web of Science ®Google Scholar
• Urso DL. Asthma in the elderly. Curr Gerontol Geriatr Res. 2009;2009:858415. doi:10.1155/2009/858415
   PubMedGoogle Scholar
• Dal negro RW, Tognella S, Guerriero M, Micheletto C. Prevalence of tracheobronchomalacia and excessive dynamic airway collapse in bronchial asthma of different severity. Multidiscip Respir Med. 2013;8(1):32. doi:10.1186/2049-6958-8-32
   PubMedGoogle Scholar
• Schleich F, Graff S, Guissard F, et al. Asthma in elderly is characterized by increased sputum neutrophils, lower airway caliber variability and air trapping. Respir Res. 2021;22:15.
   PubMed Web of Science ®Google Scholar
• Postma DS, Rabe KF. The asthma-COPD overlap syndrome. N Engl J Med. 2015;373(13):1241–1249. doi:10.1056/NEJMra1411863
   PubMed Web of Science ®Google Scholar
• Bellanti JA, Settipane RA. Atopy, asthma, and the elderly: a paradigm for personalized therapy. Allergy Asthma Proc. 2017;38(3):167–169. doi:10.2500/aap.2017.38.4056
   PubMed Web of Science ®Google Scholar
• Gibson PG, McDonald VM, Marks GB. Asthma in older adults. Lancet. 2010;376(9743):803–813. doi:10.1016/S0140-6736(10)61087-2
   PubMed Web of Science ®Google Scholar
• Tommola M, Ilmarinen P, Tuomisto LE, et al. Differences between asthma-COPD overlap syndrome and adult-onset asthma. Eur Respir J. 2017;49(5):1602383. doi:10.1183/13993003.02383-2016
   PubMed Web of Science ®Google Scholar
• Crisford H, Sapey E, Rogers GB, et al. Neutrophils in asthma: the good, the bad and the bacteria. Thorax. 2021;76(8):835–844. doi:10.1136/thoraxjnl-2020-215986
   PubMed Web of Science ®Google Scholar