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dc.contributor.authorAl-Alawi, Mazen
dc.contributor.authorHassan, Tidi
dc.contributor.authorChotirmall, Sanjay H
dc.date.accessioned2014-01-09T12:25:53Z
dc.date.available2014-01-09T12:25:53Z
dc.date.issued2013-12-28
dc.identifier.citationAdvances in the Diagnosis and Management Of Asthma in Older Adults. 2013: Am. J. Med.en_GB
dc.identifier.issn1555-7162
dc.identifier.pmid24380710
dc.identifier.doi10.1016/j.amjmed.2013.12.013
dc.identifier.urihttp://hdl.handle.net/10147/311128
dc.description.abstractGlobal 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.
dc.languageENG
dc.language.isoenen
dc.rightsArchived with thanks to The American journal of medicineen_GB
dc.subjectASTHMAen_GB
dc.subjectOLDER PEOPLEen_GB
dc.titleAdvances in the diagnosis and management of asthma in older adults.en_GB
dc.typeArticleen
dc.identifier.journalThe American journal of medicineen_GB
refterms.dateFOA2014-12-28T00:00:00Z
html.description.abstractGlobal 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.


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