Elderly asthma

Yeon-Mok Oh

doi:10.5124/jkma.2018.61.5.323

J Korean Med Assoc > Volume 61(5); 2018 > Article

Oh: Elderly asthma

Original Article

J Korean Med Assoc 2018; 61(5): 323-326.

Published online: May 17, 2018

DOI: http://dx.doi.org/10.5124/jkma.2018.61.5.323

Elderly asthma

Yeon-Mok Oh, MD

Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Corresponding author: Yeon-Mok Oh E-mail: ymoh55@amc.seoul.kr

Received January 12, 2018 Accepted January 26, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Asthma in the elderly tends to be underdiagnosed and undertreated despite its high morbidity and mortality. The diagnosis and management of asthma in the elderly is essentially the same as in adult patients. For diagnosis, spirometry is crucial, in addition to an assessment of typical symptoms; for management, the use of an inhaled corticosteroid is essential to control asthma. In elderly asthmatics, medications controlling asthma appear to be less efficacious than in younger asthmatics, and show more adverse effects. Other diseases with symptoms similar to asthma in the elderly are chronic obstructive pulmonary disease, tuberculous destroyed lung, bronchiectasis, lung cancer, and heart disease, and care should therefore be taken to differentiate these conditions from asthma. Vaccinations for influenza and pneumococcus are recommended for elderly individuals with asthma.

Key words: Asthma; Aged

Figure 1.

Prevalence of asthma according to age groups in the year 2013. The Korea National Health and Nutrition Examination Survey, South Korea. Adapted from Park SY et al. OLD 2016;4:23-32 [1].

Figure 2.

Number of asthma death according to age groups in the year 2013. Adapted from Korean Statistical Information Service. Cause of death (236 items): number of death according to sex and age [Internet]. Daejeon: Statistics Korea [2].

Table 1.

Differential points between COPD and asthma

	COPD	Asthma
Onset	Middle age or after	Infant to elderly
Typical manifestation	Slowly progressive dyspnea on exertion over years	Recurrent episodes of cough, wheeze, and dyspnea
Associated history	Smoking	Rhinitis

COPD, chronic obstructive pulmonary disease.

REFERENCES

1. Park SY, Kwon HS, Kim H, Yang HY, Cho YS. Prevalence and incidence of asthma in South Korea based on the Korea National Health and Nutrition Examination Survey. OLD 2016;4:23-32.

2. Korean Statistical Information Service. Cause of death (236 items): number of death according to sex and age [Internet]. Daejeon: Statistics Korea; 2017. [cited 2018 Jan 10]. Available from:. http://kosis.kr./statHtml/statHtml.do?orgId=101&tblId=DT_1B34E07&vw_cd=MT_ZTITLE&list_id=D11&seqNo=&lang_mode=ko&language=kor&obj_var_id=&itm_id=&conn_path=MT_ZTITLE.

3. Enright PL, McClelland RL, Newman AB, Gottlieb DJ, Lebowitz MD. Underdiagnosis and undertreatment of asthma in the elderly: Cardiovascular Health Study Research Group. Chest 1999;116:603-613.

4. Global Initiative for Asthma. Global strategy for asthma management and prevention [Internet]. Bethesda: Global Initiative for Asthma; 2018. [cited 2018 Jan 10]. Available from:. http://ginasthma.org/2018-gina-report-global-strategy-for-asthma-management-and-prevention/.

5. Cassino C, Berger KI, Goldring RM, Norman RG, Kammer-man S, Ciotoli C, Reibman J. Duration of asthma and physiologic outcomes in elderly nonsmokers. Am J Respir Crit Care Med 2000;162:1423-1428.

6. Burrows B, Barbee RA, Cline MG, Knudson RJ, Lebowitz MD. Characteristics of asthma among elderly adults in a sample of the general population. Chest 1991;100:935-942.

7. Dunn RM, Busse PJ, Wechsler ME. Asthma in the elderly and late-onset adult asthma. Allergy 2018;73:284-294.

8. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of COPD [Internet]. Bethesda: Global Initiative for Chronic Obstructive Lung Disease; 2017. [cited 2018 Jan 10]. Available from:. http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/.

9. Centers for Disease Control and Prevention. Pneumoncoccal vaccine publications [Internet]. Atlanta: Centers for Disease Control and Prevention; 2018. [cited 2018 Jan 10]. Available from:. https://www.vaccines.gov/diseases/pneumonia/index.html.