Is asthma in the elderly really different?
To examine the nature of asthma in the elderly, we compared older (group 1: 65 years or older, n = 50) with younger patients (group 2: <40 years, n = 99) and to determine the influence of long-standing disease, elderly asthmatics with early onset (group A: onset before 40, n = 22) were compared with patients developing symptoms later in their lives (group B: onset after 40, n = 22). Blood eosinophilia and IgE value >/=100 IU/l were more frequent in younger patients. Short symptom-free periods were more frequent among older asthmatics (78.5 vs. 45.4%, p < 0.001). Only 31.2% of older patients had only mild symptoms. Requirement of systemic steroids was higher in the elderly population. The worst FEV1 was lower in older patients (54.4 +/- 17.3 vs. 71.8 +/- 18.5%, p </= 0.001). Patients with early-onset asthma showed more frequently shorter symptom-free periods (93.3 vs. 53.3%, p <0.05), higher emergency admissions/year, and hospitalizations/year. Best FEV1 (group 1: 66.7 +/- 13.7% vs. group 2: 90.3 +/- 15.1%, p < 0.005) and worst FEV1 (46.2 +/- 13.1 vs. 61.0 +/- 13.2%, p < 0.01) were lower in early-onset patients. A higher systemic steroid requirement, a lower best and worst FEV1, shorter symptom-free periods and a lesser proportion of patients with only mild symptoms were observed in patients older than 65 with early-onset asthma compared with those younger than 40 years. Elderly patients with a shorter duration of asthma were not different from young patients. Our study strongly suggests that severity of asthma and development of irreversible airflow obstruction depend on the duration of disease.
Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, Argentina. ilanari@impsat1.com.ar
S A
SA
Quadrelli
A J
AJ
Roncoroni
D000328:Adult; D017668:Age of Onset; D000368:Aged; D001249:Asthma / Q000503:physiopathology* / Q000628:therapy; D004802:Eosinophilia / Q000150:complications; D005541:Forced Expiratory Volume; D006760:Hospitalization; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D013256:Steroids / Q000008:administration & dosage
D013256:Steroids; D007073:Immunoglobulin E