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    Advances in the diagnosis and management of asthma in older adults.

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    Authors
    Al-Alawi, Mazen
    Hassan, Tidi
    Chotirmall, Sanjay H
    Issue Date
    2013-12-28
    Keywords
    ASTHMA
    OLDER PEOPLE
    
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    Citation
    Advances in the Diagnosis and Management Of Asthma in Older Adults. 2013: Am. J. Med.
    Journal
    The American journal of medicine
    URI
    http://hdl.handle.net/10147/311128
    DOI
    10.1016/j.amjmed.2013.12.013
    PubMed ID
    24380710
    Abstract
    Global estimates on ageing predict an increased burden of asthma in the older population. Consequently, its recognition, diagnosis and management in clinical practice require optimization. This review aims to provide an update for clinicians highlighting advances in the understanding of the ageing process and immunosenescence together with their applicability to asthma from a diagnostic and therapeutic perspective. Ageing impacts airway responses, immune function and influences efficacy of emerging phenotype-specific therapies when applied to the elderly patient. Differentiating eosinophilic and neutrophilic disease accounts for atopic illness and distinguishes long-standing from late-onset asthma. Therapeutic challenges in drug delivery, treatment adherence and side effect profiles persist in the older patient while novel recording devices developed to aid detection of an adequate inhalation evaluates treatment effectiveness and compliance more accurately than previously attainable. Anti-cytokine therapies improve control of brittle asthma while bronchial thermoplasty is an option in refractory cases. Multi-dimensional intervention strategies prove best in the management of asthma in the older adult which remains a condition that is not rare but rarely diagnosed in this patient population.
    Item Type
    Article
    Language
    en
    ISSN
    1555-7162
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.amjmed.2013.12.013
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