title: Prevalence, risk factors and underdiagnosis of asthma and wheezing in adults 40 years and older: A population-based study.
abstract: OBJECTIVE
  There are differences in the prevalence and risk factors of asthma around the world. The epidemiological situation of adults 40 years and older is not well established. Our aim was to determine the prevalence, underdiagnosis and risk factors of asthma and wheezing in adults in Colombia.
  
  
  METHODS
  A cross-sectional, population-based study including 5539 subjects from 40 to 93 years selected by a probabilistic sampling technique in five cities was conducted.
  
  
  METHODS
  respiratory symptoms and risk factors questionnaire and spirometry.
  
  
  BACKGROUND
  (a) Wheezing: Affirmative answer to the question "have you ever had two or more attacks of "wheezes" causing you to feel short of breath?" (b) Asthma: Wheezing definition and FEV1/FVC post-bronchodilator ≥ 70%. (c) Underdiagnosis: Asthma definition without a physician-diagnosis. Logistic regression was used for exploring risk factors.
  
  
  RESULTS
  Prevalence of asthma was 9.0% (95% CI: 8.3-9.8) and wheezing 11.9% (95% CI: 11.0-12.8). Asthma underdiagnosis was 69.9% and increased to 79.0% in subjects 64 years or older. The risk factors related to asthma and/or wheezing were: living in Bogota or Medellin, female gender, first degree relative with asthma, respiratory disease before 16 years of age, obesity, no education, indoor wood smoke exposure and occupational exposure to dust particles, gases or fumes.
  
  
  CONCLUSIONS
  We described the epidemiologic situation of asthma in adults 40 years and older in Colombia. In addition to some recognized risk factors, our data supports the association of indoor wood smoke and occupational exposures with asthma and wheezing. Underdiagnosis of asthma in adults was high, particularly in older subjects.
authors.affiliation: a Research Department, Fundacion Neumologica Colombiana , Bogota , Colombia .
authors.forename: Mauricio
authors.initials: M
authors.lastname: Gonzalez-Garcia
authors.forename: Andres
authors.initials: A
authors.lastname: Caballero
authors.forename: Claudia
authors.initials: C
authors.lastname: Jaramillo
authors.forename: Dario
authors.initials: D
authors.lastname: Maldonado
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Torres-Duque
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016902:Air Pollution, Indoor; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D003105:Colombia / Q000453:epidemiology; D003296:Cooking; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012135:Respiratory Sounds; D012307:Risk Factors; D012906:Smoke; D012907:Smoking / Q000453:epidemiology; D014934:Wood
chemical_list: D012906:Smoke
keywords: Asthma; biomass; indoor air pollution; occupational exposure; prevalence; risk factors; underdiagnosis