Asthma in Older Adults

Asthma patients suffer from : 

• Coughing 
• Wheezes 
• Shortness of breath 
• Chest tightness 

These symptoms are intermittent and increase at night or with exercise. 

In the older age group, asthma has more symptom severity and lower lung function. 

Visit your Chest and Respiratory doctor if you have symptoms of asthma to be diagnosed properly 

The exact cause of asthma is unknown, but there are different triggers such as : 

• Respiratory infections 
• Allergies – as an allergy to pollen, dust mites, animal fur, or feathers 
• Smoke, fumes, and pollution 
• Medicines – particularly anti-inflammatory painkillers like ibuprofen and aspirin 
• Emotions, including stress, or laughter 
• Weather – such as sudden changes in temperature, cold air, wind, thunderstorms, heat, and humidity 
• Mold or damp 
• Exercise 

Diagnosis of late-onset asthma in the elderly is a challenge as they may consider their symptoms as a consequence of age. 

The same diagnostic procedures employed in younger populations are used for the diagnosis of the elderly however, it is more challenging to interpret the clinical data. 

Spirometry : The patient blows air into a machine that measures the amount the patient can inhale and how rapidly he can exhale it. 

FeNO test : The patient breathes into a machine that measures nitric oxide, which is a marker for lung inflammation. 

Peak-flow test : It may be done multiple times over a few weeks to evaluate if the ability to exhale quickly changes. The patient blows into a handheld gadget that measures this. 

Skin prick test : An allergen is applied to the skin in a little amount to check if it causes a reaction. 

Blood tests : A blood sample is tested to know allergens that trigger asthma symptoms. 

Other tests may be used if needed 

Most of the recommendations for treating the elderly asthmatics don’t differ from the younger population however, attention should be given to co-morbidities and the different medications used by them which may interfere with the respiratory drugs or the disease itself. 

Your doctor may prescribe you : 

Inhalers: The type of inhaler may differ according to the case. 

• Reliever inhaler : Used for acute symptoms as salbutamol. 
• Controller inhale r: It contains corticosteroids and is considered the mainstay for asthma control (ex : Fluticasone propionate). Or it can be a combination of inhaled corticosteroids with another type of medication (ex : Salmeterol & fluticasone, formoterol & mometasone, and Budesonide & formoterol). 
• Combination : Contains both reliever and corticosteroids (ex : Salbutamol & beclomethasone). 

Tablets : May be used as add-on therapy if the patient is not well controlled (ex : Montelukast,  Zafirlukast, Theophylline). 

Biologic therapy : Reserved for uncontrolled patients with documented allergies (ex : Omalizumab).