Asthma in the elderly
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SUMMARY OF PRACTICE POINTS
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| Always attempt to make the distinction between asthma and COPD, or determine that both are present, so that the optimal treatment can be prescribed |
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| Spirometry is mandatory for detecting airflow limitation in both asthma and COPD |
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| The possibilities of both asthma and COPD must be considered in all patients with cough or unexplained breathing difficulty during physical activity |
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| Demonstration of a small degree of acute reversibility to bronchodilators alone does not distinguish asthma from COPD. |
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| Avoid the use of oral corticosteroids in treatment trials in elderly patients. |
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| Warn patients that delay of effective treatment during an acute episode through over-reliance on nebulisers increases the risk of life-threatening asthma |
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| Be aware that perception of airflow limitation is reduced in older people. Always ask "Can you feel any difference after the reliever?" before measuring post-bronchodilator FEV1 |
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| Check inhaler technique and adherence whenever asthma is reviewed. |
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| Set up an effective recall process to ensure annual influenza re-vaccination and review of pneumococcal vaccination status in all elderly patients with asthma, even in those with mild asthma. |
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| Consider a PEF-based asthma action plan for patients who have shown poor perception of airflow limitation. |
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Asthma in elderly patients is more common than previously understood.1-5
- The lifetime asthma prevalence among middle-aged and older Australians is approximately 15%.4,6 Asthma prevalence in the general adult population is estimated at approximately 10-12%.7,8
- Emerging international evidence suggests that the prevalences of both asthma and chronic obstructive pulmonary disease (COPD) are increasing.9-11
The risk of dying from asthma increases with age. The majority of asthma deaths occur in people aged 65 and over, particularly during the winter months.7
Content Created (Thursday, 16 November 2006)
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Last Updated ( Thursday, 31 May 2007 )
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Asthma in the elderly 
