Asthma is often considered a “young person’s disease” but World Asthma Day reminds us that seniors are commonly affected as well.
The Centers for Disease Control and Prevention (CDC) reports that about 11 percent of those over the age of 65 have asthma. Asthma can be a continuing problem in the elder years or it can be a newly emerging illness. Most asthma-related deaths occur in older adults but many cases go undiagnosed.
Seniors with asthma are more likely to be hospitalized, remain hospitalized longer, and more likely to be admitted to a long term care facility. In addition, more medication may be required to control the condition and asthma in the elderly is not likely to go into remission, remaining a life-long problem.
Classic symptoms of asthma include:
- Tightness in the chest
- Breathing difficulty after exercise
- Excessive coughing, particularly at night or in morning
- Clear sputum productionAsthma may be precipitated by allergens such as mold or pet dander, by illnesses such as respiratory infections or by environmental conditions such as cold air, dry air, or certain odors. An asthma attack may also be caused by gastroesophageal reflux disease (GERD) and worsening of a chronic sinus condition.
Asthma may be overlooked in elderly patients, particularly if it is newly developed. The disorder may be confused with other diseases which commonly occur in older adults such as chronic obstructive pulmonary disease (COPD) or emphysema or cardiac diseases like congestive heart failure (CHF). Symptoms like “coughing” and “sputum production” are likely to be confused with chronic bronchitis or COPD, while wheezing may be attributed to CHF.
In some cases, symptoms of asthma may be disregarded if a caregiver has a perception that the symptoms are caused by a self-inflicted disease such as chronic bronchitis, emphysema or COPD which commonly occur in smokers.
Asthma symptoms in the elderly may be similar to those in younger adults but, not always. Some symptoms such as “breathing difficulty after exercise” are not likely to be noted in an elderly patient who does not do strenuous physical activity.
Certain medications may also be blamed for symptoms of asthma such as “coughing” which may be caused by ACE inhibitor medication used to control blood pressure. Beta blocker type antihypertensives may exacerbate underlying asthma.
Any symptoms of breathing difficulties should not be overlooked. Sudden symptoms may indicate a severe medical condition such as aspiration common in dementia patients or symptoms may be caused by a pulmonary embolism or lung malignancy. All respiratory symptoms should receive medical attention to determine the cause.
Though other respiratory diseases and medical conditions may have similar symptoms, a differential diagnosis will determine the cause of any breathing difficulties.