What it’s like to age with asthma

A new review published in The Lancet has revealed that older people who suffer from asthma are five times more likely to die from the condition than their younger counterparts. Unfortunately, the rate of asthma in older adults is climbing. Though the specific prevalence is debated, up to 9% of all older adults may suffer from the condition.

Why can asthma be tougher on older adults than younger adults?

For one, breathing becomes more difficult with age, even in the absence of asthma. The elasticity of the lungs diminishes as we get older, and the muscles of our respiratory systems weaken. These changes exacerbate the breathing problems that normally occur with asthma.

Another issue is that the strength of our immunes systems can decrease with age. The relevant impact is that older adults can be more likely to suffer infections that can trigger asthma attacks. Similarly, the body’s response to inflammation changes with age, so steroids that may have worked for someone with asthma in the past may stop working as they age.

According to the authors of the review, about half of older adults with asthma are not properly diagnosed, which complicates treatment and the prevention of complications. Both physicians and the patients themselves are apparently likely to blame symptoms of asthma on other conditions. For instance, people often blame their shortness of breath on being overweight or out of shape rather than considering that the symptoms represent an asthmatic condition.

Changes in cognition and motor skills are also major contributors to the heightened effects of asthma in older adults. Managing asthma requires patients to remember to take medications regularly and to deploy those medications correctly. Asthma inhalers are notoriously misused, with patients failing to get the intended doses. As patients get older and their understanding of how to use inhalers diminishes – along with their physical ability to coordinate the different aspects of using the inhalers – the chances increase that they are not getting enough medicine.

In addition to bringing more awareness to the realities of growing older with asthma and how to avoid unnecessary complications, researchers will likely aim to develop strategies to help overcome some of the challenges older adults face when dealing with asthma. Therapies that are aimed at circumventing the specific risks associated with treating asthma in the elderly could help to minimize the additional burden that asthma brings to older adults.  

Author
Dr. Summit Shah

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