An Official American Thoracic Society Workshop Report: Evaluation and Management of Asthma in the Elderly

Overview

Journal Ann Am Thorac Soc

Specialty Pulmonary Medicine

Date 2016 Nov 11

PMID 27831798

Citations 38

Authors

Gwen S Skloot

Paula J Busse

Sidney S Braman

Elizabeth J Kovacs

Anne E Dixon

Carlos A Vaz Fragoso

Nicola Scichilone

Y S Prakash

Christina M Pabelick

Sameer K Mathur

Nicola A Hanania

Wendy C Moore

Peter G Gibson

Susan Zieman

Betina B Ragless

Affiliations

Soon will be listed here.

Abstract

Asthma in the elderly (>65 yr old) is common and associated with higher morbidity and mortality than asthma in younger patients. The poor outcomes in this group are due, in part, to underdiagnosis and undertreatment. There are a variety of factors related to aging itself that affect the presentation of asthma in the elderly and influence diagnosis and management. Structural changes in the aging lung superimposed on structural changes due to asthma itself can worsen the disease and physiologic function. Changes in the aging immune system influence the cellular composition and function in asthmatic airways. These processes and differences from younger individuals with asthma are not well understood. Phenotypes of asthma in the elderly have not been clearly delineated, but it is likely that age of onset and overlap with chronic obstructive pulmonary disease impact disease characteristics. Physiologic tests and biomarkers used to diagnose and follow asthma in the elderly are generally similar to testing in younger individuals; however, whether they should be modified in aging has not been established. Confounding influences, such as comorbidities (increasing the risk of polypharmacy), impaired cognition and motor skills, psychosocial effects of aging, and age-related adverse effects of medications, impact both diagnosis and treatment of asthma in the elderly. Future efforts to understand asthma in the elderly must include geriatric-specific methodology to diagnose, characterize, monitor, and treat their disease.

Citing Articles

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