Asthma severity, atopic status, allergen exposure and quality of life in elderly persons.
BACKGROUND
Although asthma can be associated with significant airflow obstruction in those over the age of 65, it is often underdiagnosed and undertreated.


OBJECTIVE
To describe severity of asthma, allergy skin test sensitivities, indoor allergen exposures, and the impact on quality of life (QOL) and health status in elderly persons with asthma.


METHODS
A cross-sectional data analysis with 80 elderly persons with asthma recruited from medical, geriatric, and allergy/immunology tertiary care centers. Asthma severity was determined by symptoms and measurements of lung function. House dust specimens were collected from mattresses and bedroom carpets and analyzed separately for the major allergens of house dust, using monoclonal antibody-based immunoenzymetric assays. QOL was measured using Juniper's Asthma Quality of Life Questionnaire. Health status was measured using the Short Form Health Survey Medical Outcome Questionnaire which included Ferrans and Powers' Quality of Life Index subscales.


RESULTS
Two-thirds of participants had either moderate or severe persistent asthma. Skin tests to a battery of common airborne allergens were positive to at least one allergen in 56 of the 75 participants tested (74.7%). Reservoir dust allergen levels were often high enough to place participants at risk of symptoms or at risk of developing sensitization. Increased asthma severity was associated with significantly lower QOL and a trend toward decreased health status.


CONCLUSIONS
Asthma is a significant chronic problem in the elderly. Atopy was common. Asthma severity impacts on these participants' QOL and health status. Results support interventions aimed at identifying allergens precipitating attacks and reducing them in the home.
Huss
K
K
The Johns Hopkins University School of Nursing, Baltimore, Maryland 21205, USA. khuss@son.jhmi.edu
Naumann
P L
PL
Mason
P J
PJ
Nanda
J P
JP
Huss
R W
RW
Smith
C M
CM
Hamilton
R G
RG
D000368:Aged; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis; D000485:Allergens / Q000009:adverse effects; D000818:Animals; D000829:Animals, Domestic; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D015142:Baltimore / Q000453:epidemiology; D001512:Bedding and Linens; D002415:Cats; D003058:Cockroaches / Q000276:immunology; D004285:Dogs; D004363:Drug Utilization / Q000706:statistics & numerical data; D004391:Dust; D004781:Environmental Exposure; D006305:Health Status Indicators; D006798:Housing; D006801:Humans; D006813:Humidity; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D019476:Insect Proteins / Q000009:adverse effects / Q000276:immunology; D011788:Quality of Life; D012720:Severity of Illness Index; D012882:Skin Tests; D012907:Smoking / Q000453:epidemiology; D013147:Spirometry; D014505:Urban Population
D000485:Allergens; D018927:Anti-Asthmatic Agents; D004391:Dust; D019476:Insect Proteins