title: Older adults with asthma: does age of asthma onset make a difference?
abstract: OBJECTIVE
  Older adults with asthma can develop symptoms early in life or during adulthood. Differences between these groups may have diagnostic and therapeutic implications. Our goal was to identify differences in demographics, control, quality of life and healthcare utilization between those with long-standing asthma (LSA) and late-onset asthma (LOA).
  
  
  METHODS
  Data from a cross-sectional study of asthma patients over age 65 were analyzed. LSA or LOA was based on age of diagnosis (before or after age 40). Demographic and asthma specific information were analyzed, and allergy prick tests and lung function testing (spirometry and FENO) were performed.
  
  
  RESULTS
  After regression analysis, LSA subjects were more likely to demonstrate positive prick tests (92 versus 71%, p = 0.04), with both groups demonstrating higher levels of atopy than previously reported. LSA subjects were also more likely to have received a peak flow meter (p = 0.07). LOA subjects were more likely to have moderate or severe asthma (OR = 3.1, p = 0.05), and had higher FENO readings (p = 0.02). They also had more hospitalizations (p = 0.04), though significance was lost after regression analysis. No differences were noted in demographic information, medical comorbidities, spirometry, compliance, asthma control, or asthma quality of life between LSA and LOA subjects.
  
  
  CONCLUSIONS
  LSA subjects are more atopic and more likely to be given a peak flow meter, while LOA subjects have higher FENO levels and more severe asthma. Defining age of asthma onset may help improve treatment recommendations and outcomes for older adults.
authors.affiliation: Department of Internal Medicine, Division of Allergy and Clinical Immunology , and.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Baptist
authors.forename: Jacqueline A
authors.initials: JA
authors.lastname: Ross
authors.forename: Noreen M
authors.initials: NM
authors.lastname: Clark
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology* / Q000503:physiopathology; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D011788:Quality of Life; D012959:Socioeconomic Factors; D013147:Spirometry; D011795:Surveys and Questionnaires
chemical_list: D009569:Nitric Oxide