From Our 2012 Archives
Asthma an Often Unrecognized Risk for Older People
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Study Shows That Older Adults With Asthma Often Face Serious Health Risks
By Denise Mann
Reviewed by Louise Chang, MD
May 4, 2012 -- Asthma is not just dangerous for kids.
People over 65 also have asthma and often face an uphill health battle as a result, a new study suggests. Once hospitalized, these individuals are 14 times more likely to die from asthma than younger adults. What's more, asthma increases their risk for impaired lung function and a worse quality of life.
Part of the reason for the poor outcomes is that asthma is often misdiagnosed and undertreated among older adults. When an older person becomes short of breath or has tightness in their chest, they -- as well as their doctors -- may attribute it to age, being out of shape, or even to their heart, instead of asthma.
According to the study, just 53% of older adults with asthma reported using a steroid inhaler in the past month. Inhaled steroids are the standard treatment used to control asthma.
The study included 77 people aged 60 and older with and without asthma. Of these, 89% of people with asthma also had allergies to allergens including mold, animals, and dust mites. Individuals with asthma were also more likely to report poor health and body pain compared to those without asthma. Hay fever, arthritis, and diabetes were also more common among people with asthma, the study shows.
The findings appear in the May issue of the Annals of Allergy, Asthma, and Immunology.
Asthma Often Misdiagnosed, Undertreated in 60-Plus Sect
"The findings mirror what I see in practice," says David Beuther, MD. He is an assistant professor of medicine at National Jewish Health in Denver, Colo. "We are seeing more asthma in older people," he says. "There is a perception that adults don't get asthma, only kids do, so it must be something else."
Both patients and their doctors may attribute asthma symptoms to other factors. "Not all shortness of breath is from being out of shape or the heart, but these individuals are thought of as cardiac patients and people forget to do the pulmonary evaluation," Beuther says.
Symptoms of asthma in adults are the same as in children and include:
"You don't have to have all of these to have asthma," he says. If properly diagnosed, asthma is treatable.
Asthma Treatment Makes a Difference
Neil Schachter, MD, agrees. He is a professor of pulmonary medicine at Mount Sinai School of Medicine in New York City. "Any adult with recurrent episodes of chest tightness, wheeze, and shortness of breath should consult their physician," he says. "This is not a normal part of aging."
Treatment depends on the severity of the asthma. It is important that these individuals get their annual flu vaccine and be up to date with their pneumococcal vaccine, as they are considered high risk based on their age and the asthma.
Louisville, Ky.-based allergist James Sublett, MD, says many times adults with asthma had it as children. "They think they outgrew it, but they didn't," he says. Sublett is also the chair of the American College of Allergy, Asthma, and Immunology's public relations committee.
SOURCES: Smoth, A.M. Annals of Allergy, Asthma and Immunology, May 2012. David Beuther, MD, assistant professor of medicine, National Jewish Health, Denver, Colo. Neil Schachter, MD, professor, pulmonary medicine, Mount Sinai School of Medicine, New York City. James Sublett, MD, allergist, Louisville, Ky.