PMID- 30656998
OWN - NLM
STAT- MEDLINE
DCOM- 20201127
LR  - 20201127
IS  - 1532-4303 (Electronic)
IS  - 0277-0903 (Linking)
VI  - 57
IP  - 3
DP  - 2020 Mar
TI  - Asthma in the older adult.
PG  - 241-252
LID - 10.1080/02770903.2019.1565828 [doi]
AB  - Objective: The older adult population is increasing worldwide, and a significant 
      percentage has asthma. This review will discuss the challenges to diagnosis and 
      management of asthma in older adults. Data Sources: PubMed was searched for 
      multiple terms in various combinations, including asthma, older adult, elderly, 
      comorbid conditions, asthma diagnosis, asthma treatment, biologics and medication 
      side effects, and adverse events. From the search, the data sources that were 
      utilized included peer reviewed scholarly review articles, peer reviewed 
      scientific research articles, and peer reviewed book chapters. Study Selections: 
      Study selections that were utilized included peer reviewed scholarly review 
      articles, peer reviewed scientific research articles, and peer reviewed book 
      chapters. Results: Asthma in older adults is frequently underdiagnosed and has 
      higher morbidity and mortality rates compared to their younger counterparts. A 
      detailed history and physical examination as well as judicious testing are 
      essential to establish the asthma diagnosis and exclude alternative ones. Medical 
      comorbidities, such as cardiovascular disease, cognitive impairment, depression, 
      arthritis, gastroesophageal reflux disease (GERD), rhinitis, and sinusitis are 
      common in this population and should also be assessed and treated. 
      Non-pharmacologic management, including asthma education on inhaler technique and 
      self-monitoring, is vital. Pharmacologic management includes standard asthma 
      therapies such as inhaled corticosteroids (ICS), inhaled corticosteroid-long 
      acting beta-agonist combinations (ICS-LABA), leukotriene antagonists, long acting 
      muscarinic antagonists (LAMA), and short acting bronchodilators (SABA). Newly 
      approved biologic agents may also be utilized. Older adults are more vulnerable 
      to polypharmacy and medication adverse events, and this should be taken into 
      account when selecting the appropriate asthma treatment. Conclusions: The 
      diagnosis and management of asthma in older adults has certain challenges, but if 
      the clinician is aware of them, the morbidity and mortality of this condition can 
      be improved in this growing population.
FAU - Nanda, Anil
AU  - Nanda A
AD  - Asthma and Allergy Center, Lewisville and Flower Mound, TX, USA.
AD  - Division of Allergy and Immunology, University of Texas Southwestern Medical 
      Center, Dallas, TX, USA.
FAU - Baptist, Alan P
AU  - Baptist AP
AD  - Division of Allergy and Immunology, University of Michigan School of Medicine, 
      Ann Arbor, MI, USA.
FAU - Divekar, Rohit
AU  - Divekar R
AD  - Division of Allergy and Immunology, Mayo Clinic, Rochester, MN, USA.
FAU - Parikh, Neil
AU  - Parikh N
AD  - Capital Allergy and Respiratory Disease Center, Sacramento, CA, USA.
FAU - Seggev, Joram S
AU  - Seggev JS
AD  - Department of Internal Medicine, Roseman University College of Medicine, Las 
      Vegas, NV, USA.
FAU - Yusin, Joseph S
AU  - Yusin JS
AD  - Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
AD  - David Geffen School of Medicine, University of California Los Angeles, Los 
      Angeles, CA, USA.
FAU - Nyenhuis, Sharmilee M
AU  - Nyenhuis SM
AD  - Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois 
      at Chicago, Chicago, IL, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190118
PL  - England
TA  - J Asthma
JT  - The Journal of asthma : official journal of the Association for the Care of 
      Asthma
JID - 8106454
RN  - 0 (Anti-Asthmatic Agents)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Anti-Asthmatic Agents/*therapeutic use
MH  - Asthma/complications/*diagnosis/*drug therapy/epidemiology
MH  - Comorbidity
MH  - Disease Progression
MH  - Humans
MH  - Polypharmacy
MH  - Quality of Life
OTO - NOTNLM
OT  - ACOS
OT  - Asthma
OT  - COPD
OT  - diagnosis
OT  - education
OT  - elderly
OT  - older adult
OT  - treatment
EDAT- 2019/01/19 06:00
MHDA- 2020/11/28 06:00
CRDT- 2019/01/19 06:00
PHST- 2019/01/19 06:00 [pubmed]
PHST- 2020/11/28 06:00 [medline]
PHST- 2019/01/19 06:00 [entrez]
AID - 10.1080/02770903.2019.1565828 [doi]
PST - ppublish
SO  - J Asthma. 2020 Mar;57(3):241-252. doi: 10.1080/02770903.2019.1565828. Epub 2019 
      Jan 18.