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    Diagnosis and management of asthma in older adults.

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    Authors
    Chotirmall, Sanjay Haresh
    Watts, Michael
    Branagan, Peter
    Donegan, Ciaran F
    Moore, Allan
    McElvaney, Noel Gerard
    Affiliation
    Department of Medicine, Respiratory Research Division, Education & Research Centre, Beaumont Hospital, Dublin 9, Republic of Ireland. schotirmall@rcsi.ie
    Issue Date
    2009-05
    MeSH
    Aged
    Anti-Asthmatic Agents
    Asthma
    Drug Delivery Systems
    Humans
    Respiratory Function Tests
    
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    Citation
    Diagnosis and management of asthma in older adults. 2009, 57 (5):901-9 J Am Geriatr Soc
    Journal
    Journal of the American Geriatrics Society
    URI
    http://hdl.handle.net/10147/127507
    PubMed ID
    19484848
    Abstract
    Despite comprehensive guidelines established by the European Global Initiative for Asthma and the U.S. National Asthma Education and Prevention Program on the diagnosis and management of asthma, its mortality in older adults continues to rise. Diagnostic and therapeutic problems contribute to older patients being inadequately treated. The diagnosis of asthma rests on the history and characteristic pulmonary function testing (PFT) with the demonstration of reversible airway obstruction, but there are unique problems in performing this test in older patients and in its interpretation. This review aims to address the difficulties in performing and interpreting PFT in older patients because of the effects of age-related changes in lung function on respiratory physiology. The concept of "airway remodeling" resulting in "fixed obstructive" PFT and the relevance of atopy in older people with asthma are assessed. There are certain therapeutic issues unique to older patients with asthma, including the increased probability of adverse effects in the setting of multiple comorbidities and issues surrounding effective drug delivery. The use of beta 2-agonist, anticholinergic, corticosteroid, and anti-immunoglobulin E treatments are discussed in the context of these therapeutic issues.
    Item Type
    Article
    Language
    en
    ISSN
    1532-5415
    Collections
    Beaumont Hospital

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