title: Changes in FVC during methacholine-induced bronchoconstriction in elderly patients with asthma: bronchial hyperresponsiveness and aging.
abstract: OBJECTIVE
  We evaluated whether aging may produce changes in bronchial hyperresponsiveness, risk of enhanced bronchoconstriction, and changes of bronchoconstriction perception.
  
  
  METHODS
  Each subject underwent a methacholine bronchial challenge. Methacholine challenge was stopped when one of the following conditions occurred: (1) plateau of bronchoconstriction; (2) decrease of FEV(1) > 40%; (3) FEV(1) drop below 1 L; or (4) excessive respiratory discomfort. Methacholine dose-response curves were plotted both for FVC and FEV(1). The provocative dose of methacholine causing a 20% decrease in FEV(1) with respect to baseline (PD(20)) and the fall in FVC (DeltaFVC) at PD(20) were computed. The Borg scale was used for scoring the perception of respiratory discomfort.
  
  
  METHODS
  We compared 17 young asthmatic patients (aged 22 to 45 years) with 17 older asthmatic patients (aged 63 to 78 years) selected on the basis of similar baseline pulmonary function and disease duration.
  
  
  RESULTS
  No significant between-group difference was found in PD(20) and in plateau development. Conversely, DeltaFVC was significantly higher in the older group (mean +/- SD, 15.5 +/- 3.9% vs 11.6 +/- 5.5% in younger patients). In addition, DeltaFVC showed a positive linear relationship with age (p = 0.0026). Elderly subjects were less aware of bronchoconstriction during the methacholine challenge (p = 0.04).
  
  
  CONCLUSIONS
  In elderly patients with asthma having comparable pulmonary function and disease duration, bronchial responsiveness is not different from that observed in younger asthmatic patients. Nevertheless, in such patients, an age-related tendency to an enhanced bronchoconstriction and a reduced perception of the degree of bronchoconstriction exist.
authors.affiliation: Istituto di Fisiopatologia Respiratoria del C.N.R., Palermo, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cuttitta
authors.forename: F
authors.initials: F
authors.lastname: Cibella
authors.forename: V
authors.initials: V
authors.lastname: Bellia
authors.forename: V
authors.initials: V
authors.lastname: Grassi
authors.forename: S
authors.initials: S
authors.lastname: Cossi
authors.forename: S
authors.initials: S
authors.lastname: Bucchieri
authors.forename: G
authors.initials: G
authors.lastname: Bonsignore
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D001249:Asthma / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000503:physiopathology*; D016085:Bronchoconstrictor Agents; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D016210:Methacholine Chloride; D008875:Middle Aged; D014797:Vital Capacity / Q000502:physiology*
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride