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Editorials |

Difficulties With Diagnosing Asthma in the Elderly

LTC Michael J. Morris, MC, USA (Fort Sam Houston, TX)
Author and Funding Information

LTC Morris is a member of the Medical Corps, Brooke Army Medical Center, Fort Sam Houston, TX.

Correspondence to: Michael J. Morris, Lieutenant Colonel, Medical Corps, Pulmonary Disease/Critical Care Service, Department of Medicine, Brooke Army Medical Center, 3851 Roger Brooke Dr, Fort Sam Houston, TX 78234; e-mail: Michael.Morris@cen.amedd.army.mil



Chest. 1999;116(3):591-593. doi:10.1378/chest.116.3.591
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Extract

National trends in the morbidity and mortality associated with asthma have demonstrated that this is a common disease in the elderly. Evans et al1 reported in 1987 that the rate for active asthma was 10.4% for 65- to 74-year-olds, with lower rates found in all other age groups. Mortality studies in the United States from 1977 and 1982, respectively, demonstrated a higher per capita death rate of 3.0 and 4.9 per 100,000 for adults 65 to 74 years old, compared to 0.5 and 0.6 per 100,000 for younger adults > 35 years old.1 Similar findings have been reported elsewhere. Burr et al2 reported on a south Wales town where there was a 6.5% rate for history of asthma for persons > 70 years old, and 2.9% with active disease. A review of asthma mortality in England found that 58% of the male patients and 71% of the female patients whose deaths were attributable to asthma were > 70 years old.3 A study by Barger et al4 in 1982 showed similar findings, where 80% of asthma deaths were in persons> 55 years old. However, there were many confounding factors in these deaths, including COPD and nonrespiratory problems, and only 33% of these patients died from pure asthma. Since these reports, the National Institutes of Health (NIH) published initially in 1991 and again in 1997 several guidelines for all clinicians on the diagnosis and management of asthma. The NIH published another guideline in 1996 to specifically address asthma diagnosis and management in the elderly.


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asthma ; elderly

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