Asthma in the elderly (.65 yr old) is common and associated with higher morbidity and mortality than asthma in younger patients. The poor outcomes in this group are due, in part, to underdiagnosis and undertreatment.There are a varietyof factors related toagingitself that affect the presentation of asthma in the elderly and influence diagnosis and management. Structural changes in the aging lung superimposed on structural changes due to asthma itself can worsen the disease and physiologic function. Changes in the aging immune system influence the cellular compositionandfunction inasthmatic airways.Theseprocesses and differences from younger individuals with asthma are not well understood. Phenotypes of asthmain the elderlyhavenot been clearlydelineated, but it is likely that age of onset and overlap with chronic obstructive pulmonary disease impact disease characteristics. Physiologic tests and biomarkers used to diagnoseandfollow asthmaintheelderly are generally similar to testing in younger individuals;however,whether they shouldbemodified in aginghas not been established. Confounding influences, such as comorbidities (increasing the risk of polypharmacy), impaired cognition and motor skills, psychosocial effects of aging, and age-related adverse effects ofmedications, impact both diagnosis and treatment of asthma in the elderly. Future efforts to understand asthma in the elderly must include geriatric-specific methodology to diagnose, characterize, monitor, and treat their disease.
- Lung function
- Reactive airways disease
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine