02787nas a2200337 4500008004100000022001400041245010800055210006900163260001300232300001100245490000800256520186600264653001602130653000902146653002202155653001102177653001102188653001102199653000902210653003002219653002002249653001702269653001502286653001902301100001802320700002102338700001702359700001902376700001902395856003502414 1999 eng d a0012-369200aUnderdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group.0 aUnderdiagnosis and undertreatment of asthma in the elderly Cardi c1999 Sep a603-130 v1163 a

OBJECTIVE: To describe the clinical correlates of asthma in a community-based sample of elderly persons.

PARTICIPANTS: A community sample of 4,581 persons > or = 65 years old from the Cardiovascular Health Study.

MEASUREMENTS: Standardized respiratory, sleep, and quality-of-life (QOL) questions, a medication inventory, spirometry, and ambulatory peak flow.

RESULTS: Four percent of the participants reported a current diagnosis of asthma (definite asthma), while another 4% reported at least one attack of wheezing accompanied by chest tightness or dyspnea during the previous 12 months (probable asthma). Smokers and those with congestive heart failure were excluded from the subsequent analyses, leaving 2,527 participants. Of those who had definite asthma, 40% were taking a sympathomimetic bronchodilator, 30% inhaled corticosteroids, 21% theophylline, and 18% oral corticosteroids; 39% were taking no asthma medications. The participants with definite or probable asthma were much more likely than the others to have a family history of asthma, childhood respiratory problems, a history of workplace exposures, dyspnea on exertion, hay fever, chronic bronchitis, nocturnal symptoms, and daytime sleepiness. They were also more likely to report poor general health, symptoms of depression, and limitation of activities of daily living. There was little difference in the morbidity and QOL of participants with recent asthma-like symptoms who had received the diagnosis of asthma versus those who had not.

CONCLUSIONS: Asthma in elderly persons is associated with a lower QOL and considerable morbidity when compared with those who do not have asthma symptoms. Asthma is underdiagnosed in this group and is often associated with allergic triggers; inhaled corticosteroids are underutilized.

10aAge Factors10aAged10aAged, 80 and over10aAsthma10aFemale10aHumans10aMale10aPeak Expiratory Flow Rate10aQuality of Life10aRisk Factors10aSpirometry10aVital Capacity1 aEnright, P, L1 aMcClelland, R, L1 aNewman, A, B1 aGottlieb, D, J1 aLebowitz, M, D uhttps://chs-nhlbi.org/node/601