When people think of asthma, they often associate it with children. But did
you know that asthma is increasing among people over 65 years of age? Unfortunately,
asthma cases among people over 65 often go undiagnosed, or even misdiagnosed.
Unlike young people with asthma, whose main symptom is wheezing, seniors usually
complain of a chronic cough. For this reason, asthma in older adults may be
overlooked or misdiagnosed as the common cold or cough. Other symptoms may
include wheezing, shortness of breath, fatigue, and weight loss.
Asthma in people over 65 often occurs among former smokers and those with
emphysema, chronic bronchitis, or other conditions
related to chronic obstructive pulmonary disease
(COPD). Sometimes, it is hard to distinguish asthma from other conditions.
For example, pulmonary edema, which is caused by heart failure, can cause asthma-like
symptoms, such as wheezing. This is sometimes referred to as "cardiac asthma." A
correct diagnosis is critical because the treatment of the two diseases is
Viral respiratory illnesses (e.g., influenza and the common cold virus) and
tobacco smoke are the main triggers for adults with asthma. However, common
asthma culprits such as dust mites, pet dander, pollen, and molds can also
affect people over 65, especially those who spend a lot of time in the home.
Lack of exercise or healthy foods may also contribute to poor lung health.
Before you begin any asthma treatment plan, discuss with your doctor any other
medications you are taking. Some asthma drugs have adverse side effects when
mixed with other drugs. Your doctor may provide a written treatment plan that
helps you keep track of your medications.
The National Asthma Education and Prevention Program (NAEPP) has conducted
a Systematic Review of the Evidence (SRE) of the long-term safety of certain
asthma medications. Many physicians rely on this review and the accompanying
guidelines when managing asthma. Nevertheless, it should be noted that the
SRE may not apply to elderly adults. For instance, the review looks at the
impact of steroid medications on height growth (not directly applicable to
the aging), but not at issues for the aging, including bone mineral density
and eye side effects (such as cataracts) that are likely to occur more frequently
as age increases.
National Asthma Education and Prevention Program Expert Panel Report: guidelines
for the diagnosis and management of asthma update on selected topics -- 2002. J
Allergy Clin Immunol. 2002 Nov;110(Suppl 5):S141-219.
National Asthma Education and Prevention Program Expert Panel Report 2:
guidelines for the diagnosis and management of asthma. Bethesda (MD):
U.S. Department of Health and Human Services, Public Health Service, National
Institutes of Health, National Heart, Lung and Blood Institute; 1997 Jul.
NIH Publications 97-4051.
Williams SG, Schmidt DK, Redd SC, Storms W. Key clinical activities for quality
asthma care: recommendations of the National Asthma Education and Prevention
Program. MMWR Recomm Rep. 2003 Mar 28;52(RR-6):1-8.
Review Date: 5/16/2007
Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.
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