Asthma: new insights in the management of older adults

Making a diagnosis of asthma is often complicated, especially in the older patient. Problems that are specific to this population include a larger reduction in pulmonary function than is suggested by the patient evaluation, a higher rate of comorbid diagnosis of COPD and other chronic disease, as well as an increased risk of death associated with asthma. Older patients may also have reduced awareness of bronchial constriction or airway obstruction, which may delay their seeking of medical care. For this reason, measurements of air flow are critical to objectively assess the severity of acute asthma in the older patient. Special concerns in patients over age 50 include exacerbation of co-existing heart disease and potential interactions with medications used for other chronic conditions.