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Asthma is a chronic respiratory ailment that requires careful management due to its varying symptoms and influencing factors. It is characterized by airway inflammation, bronchial hyperresponsiveness, and reversible airflow obstruction, leading to symptoms like wheezing, shortness of breath, chest tightness, and coughing. The symptom frequency and intensity may vary considerably over time. It is also linked to immune system responses to allergens and irritants, highlighting the complex...
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Asthma in Individuals Over 60 Years: A Comparative Analysis Across Age Subgroups.

Martyna Miodońska1, Andrzej Bożek1, Ewa Urbaniec2

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Summary

Older adults with asthma often experience undertreatment, leading to poorer control and reduced quality of life, especially in those over 80. This highlights the need for better asthma management in the elderly population.

Keywords:
FOTasthma phenotypeselderlylate-onset asthmaquality of lifespirometry

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Area of Science:

  • Gerontology
  • Pulmonology
  • Clinical Medicine

Background:

  • Asthma management in individuals over 60 is challenging due to atypical symptoms, overlapping comorbidities, and diagnostic difficulties.
  • Older adults with asthma often present with atypical symptoms, complicating diagnosis and treatment.
  • Comorbidities frequently overlap with asthma symptoms, leading to diagnostic uncertainty and undertreatment in the elderly population.

Purpose of the Study:

  • To evaluate asthma control, phenotypes, comorbidities, and quality of life in patients aged 60 and older.
  • To assess treatment patterns for asthma in older adults, including specific age subgroups.
  • To investigate the impact of asthma on quality of life and general health in the geriatric population.

Main Methods:

  • A multicenter, cross-sectional study involving 345 asthma patients over 60 and 410 matched controls.
  • Utilized spirometry, Forced Oscillation Technique (FOT), and bronchodilator reversibility testing.
  • Assessed patient-reported outcomes using Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), and SF-36 survey.

Main Results:

  • 25% of asthma patients had severe asthma; 48% presented with the T2 phenotype.
  • Asthma patients showed higher rates of depression, cognitive decline, and multimorbidity compared to controls (p<0.05).
  • Asthma patients reported lower quality of life (AQLQ scores) and older adults over 80 had poorer asthma control and reduced quality of life (SF-36 scores).

Conclusions:

  • Asthma in older age is frequently linked to comorbidities, significantly impacting quality of life and overall health.
  • Patients aged 60 and over are often undertreated for asthma, resulting in suboptimal disease control.
  • The oldest patients (over 80) experience particularly poorer asthma control and diminished quality of life, underscoring a critical need for tailored interventions.