title: Characteristics and outcomes of older adults with long-standing versus late-onset asthma.
abstract: To examine the effect of age of onset on clinical characteristics and outcomes in a cohort of older patients with long-standing (LSA) and late-onset asthma (LOA).
  
  
  
  In all, 452 patients 60 years of age and older with persistent asthma were recruited. We defined LOA as asthma developing at age 40 or later and LSA as developing before age 40. We compared airway obstruction as assessed by spirometry, as well as asthma control using the Asthma Control Questionnaire (ACQ), quality of life using the Mini Asthma Quality of Life Questionnaire (AQLQ), and asthma-related emergency department visits and hospitalizations among patients with LSA vs. LOA.
  
  
  
  Patients with LOA, were less likely to have FEV1<70% of predicted (23% vs. 40%, p = 0.0002), to have FEV1/FVC<0.7 (27% vs. 38%, p = 0.01), or to have been intubated in the past (5% vs. 14%, p = 0.0007), and were also less likely to report a history of allergic conditions (64% vs 76%, p = 0.007). There was no significant difference in the level of asthma control, quality of life, or health care utilization.
  
  
  
  Older adults with LOA have different clinical and physiological characteristics and outcomes compared to those with LSA. Some of these differences may represent sequelae of longstanding disease, however LOA may also represent a different clinical phenotype that could influence management approaches.
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Herscher
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Wisnivesky
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Busse
authors.affiliation: b Baylor College of Medicine , Houston , TX , USA.
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Hanania
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Tianyun
authors.initials: T
authors.lastname: Sheng
authors.affiliation: c Feinberg School of Medicine at Northwestern University , Chicago , IL , USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.affiliation: a Icahn School of Medicine at Mount Sinai , New York , NY , USA.
authors.forename: Alex D
authors.initials: AD
authors.lastname: Federman
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000402:Airway Obstruction; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000145:classification* / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009330:Nebulizers and Vaporizers; D011788:Quality of Life; D012129:Respiratory Function Tests; D012959:Socioeconomic Factors
chemical_list: D018927:Anti-Asthmatic Agents; D001993:Bronchodilator Agents
keywords: Elderly; allergy; phenotypes; spirometry