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asthma in the elderly

Clinical manifestations: 1) not all that wheezes is asthma (see differential diagnosis) 2) similar to adults (see asthma) Special laboratory: - spirometry a) in elderly patients, incomplete reversibility of obstructive airway disease is common b) COPD is common Differential diagnosis: 1) myocardial infarction 2) congestive heart failure 3) pulmonary embolism 4) COPD 5) GERD 6) also see dyspnea Management: 1) general a) follow recommendations for adults but with considerations of polypharmacy & comorbidities b) patient/family/caregiver education to encourage compliance c) screening for psychosocial, physical, cognitive, & environmental barriers to asthma control & self-management with actions to address identified barriers [7] 2 pharmacologic therapy a) use stepwise approach b) also see COPD as this is a common comorbidity

Related

age-associated changes in pulmonary function elderly (senior citizen)

General

asthma geriatric disorder; disease of old age; geriatric syndrome

References

  1. Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
  2. Mathur SK. Allergy and asthma in the elderly. Semin Respir Crit Care Med. 2010 Oct;31(5):587-95 PMID: 20941659
  3. Hanania NA, King MJ, Braman SS et al Asthma in the elderly: Current understanding and future research needs--a report of a National Institute on Aging (NIA) workshop. J Allergy Clin Immunol. 2011 Sep;128(3 Suppl):S4-24 PMID: 21872730
  4. Gibson PG, McDonald VM, Marks GB. Asthma in older adults. Lancet. 2010 Sep 4;376(9743):803-13. Review. PMID: 20816547
  5. Jones SC, Iverson D, Burns P, Evers U, Caputi P, Morgan S. Asthma and ageing: an end user's perspective--the perception and problems with the management of asthma in the elderly. Clin Exp Allergy. 2011 Apr;41(4):471-81. Review. PMID: 21395876
  6. Reed CE. Asthma in the elderly: diagnosis and management. J Allergy Clin Immunol. 2010 Oct;126(4):681-7; Review. PMID: 20673985
  7. Federman AD, O'Conor R, Mindlis I et al. Effect of a self-management support intervention on asthma outcomes in older adults: The SAMBA study randomized clinical trial. JAMA Intern Med 2019 Jun 10; PMID: 31180474 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2735448
  8. http://www.nhlbi.nih.gov/health/prof/lung/asthma/as_elder.htm