Objective: To describe the clinical correlates of
asthma in a community-based sample of elderly persons.
Participants: A community sample of 4,581 persons ≥ 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