title: An assessment of methacholine inhalation tests in elderly asthmatics.
abstract: We have assessed the feasibility and value of measuring nonspecific bronchial responsiveness to methacholine in investigation of asthma in the elderly. Results from duplicated tests in 20 subjects aged 65-82 years were expressed as dose provoking a 20% decrement in 1 second forced expiratory volume (PD20.FEV1) or peak expiratory flow (PD20.PEF). Repeatability for PD20.FEV1 was satisfactory but less good than in younger subjects, 95% confidence limits being 0.39-2.57 and 0.52-1.91, respectively, x initial PD20. For PD20.PEF, confidence limits were wider (0.26-3.91 x initial PD20) but multiple PEF measurements were better tolerated than those of FEV1, which commonly caused fatigue and dizziness. PD20.FEV1 and PD20.PEF correlated closely (r = 0.95, P less than 0.0001) and both predicted bronchodilatation following a 6-week course of inhaled corticosteroid and beta agonist. This was not predicted by the response to a single dose of beta agonist. We conclude that measurement of bronchial responsiveness is feasible and clinically valuable in elderly subjects.
authors.affiliation: Department of Respiratory Medicine, Newcastle General Hospital, University of Newcastle upon Tyne.
authors.forename: M J
authors.initials: MJ
authors.lastname: Connolly
authors.forename: C
authors.initials: C
authors.lastname: Kelly
authors.forename: E H
authors.initials: EH
authors.lastname: Walters
authors.forename: D J
authors.initials: DJ
authors.lastname: Hendrick
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D001507:Beclomethasone / Q000627:therapeutic use; D001985:Bronchial Provocation Tests / Q000379:methods*; D004244:Dizziness / Q000139:chemically induced; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D008688:Methacholine Compounds / Q000009:adverse effects; D010366:Peak Expiratory Flow Rate
chemical_list: D008688:Methacholine Compounds; D016210:Methacholine Chloride; D001507:Beclomethasone; D000420:Albuterol