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Differences between asthma and COPD in the elderly.

B A Sin1, O Akkoca, S Saryal

  • 1Division of Allergic Diseases, School of Medicine, Ankara University, Ankara, Turkey. bsin@medicine.ankara.edu.tr

Journal of Investigational Allergology & Clinical Immunology
|April 8, 2006
PubMed
Summary

Differentiating asthma and chronic obstructive pulmonary disease (COPD) in older adults is challenging. Atopy and bronchodilator response suggest asthma, while smoking history and reduced lung diffusing capacity indicate COPD.

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Area of Science:

  • Pulmonology
  • Geriatric Medicine
  • Allergy Immunology

Background:

  • Asthma and COPD present with airflow obstruction, frequently co-occurring in the elderly.
  • Clinical differentiation between asthma and COPD in older adults can be difficult.

Purpose of the Study:

  • To compare clinical, functional, and atopic characteristics of late-onset asthma versus COPD in elderly patients.
  • To identify distinguishing features aiding diagnosis in older individuals with airflow obstruction.

Main Methods:

  • Study included 51 patients over 60 (27 late-onset asthma, 24 COPD).
  • Assessed atopy via skin prick tests and serum IgE.
  • Performed pulmonary function tests (spirometry, lung volumes, diffusing capacity) and arterial blood gases.

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Main Results:

  • Asthmatics showed higher atopy rates (skin prick test positivity).
  • COPD patients had lower FEV1 and significantly decreased diffusing capacity for carbon monoxide (DLCO).
  • Asthmatics exhibited greater bronchial reversibility; COPD patients had differing PO2 and PCO2 levels.

Conclusions:

  • Atopy and significant bronchodilator responsiveness favor asthma diagnosis in the elderly.
  • Heavy smoking history, lung hyperinflation, hypoxemia, and reduced DLCO suggest COPD in older adults.