title: Comorbidities in elderly patients with asthma: Association with control of the disease and concomitant treatment.
abstract: OBJECTIVE
  The incidence of concomitant conditions increases with age. In elderly patients, the presence of comorbidities has been related to the course and severity of asthma. The aim of the present study was to assess the impact of comorbidities and concomitant treatment on asthma control and severity in older adults.
  
  
  METHODS
  A total of 93 elderly (age >65 years) and 78 younger (age 30-50 years) asthmatic patients were randomly selected from a database including 1755 asthmatics. Evaluation consisted of a questionnaire, spirometry and skin prick testing.
  
  
  RESULTS
  In elderly asthmatics, a higher incidence of chronic comorbidities (mean 8.4 vs 4.7; P < 0.001) and a higher number of prescribed medicines (7.4 vs 4.5, P < 0.001) were observed, but the severity of asthma and the intensity of anti-asthma treatment were similar to that seen in younger patients. Asthma control was not strikingly different between the groups. There was no correlation between the presence of comorbid conditions and asthma control, severity or frequency of exacerbations in older patients. Elderly patients treated with statins had a lower risk of asthma exacerbation (OR 0.39, 95% CI 0.18-0.84, P = 0.017), whereas treatment with proton pump inhibitors was associated with a higher risk of exacerbations in older adults (OR 1.84, 95% CI 1.07-3.18, P = 0.029) and higher disease severity in younger patients (OR 2.49, 95% CI 1.1-5.67, P = 0.029).
  
  
  CONCLUSIONS
  The higher prevalence of comorbidities observed in elderly asthmatics under specialist care do not seem to be associated with worsened asthma control or severity. However, concomitant medications can significantly affect asthma control in both elderly and younger asthmatics.
authors.affiliation: Department of Clinical Immunology, Rheumatology and Allergy, Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Wardzyńska
authors.affiliation: Public Health Care Center, Gostynin, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Kubsik
authors.affiliation: Department of Clinical Immunology, Rheumatology and Allergy, Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland.
authors.forename: Marek Leszek
authors.initials: ML
authors.lastname: Kowalski
mesh_terms: D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000517:prevention & control; D015897:Comorbidity / Q000639:trends; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: bronchial asthma; comorbidity; drug polytherapy; elderly; exacerbation