Scope of the Burden of Asthma in Older Adults

Asthma is a prevalent condition in older adults, and the prevalence continues to rise. Asthma tends to be more severe in older adults, including higher morbidity and mortality, higher financial costs, and lower asthma-related quality of life. Diagnosis is confounded by poor recognition of symptoms, confusion with potential comorbid diseases, and greater difficulty completing objective testing in older adults. Once a diagnosis is made, older asthmatics tend to be undertreated relative to their younger counterparts. Treatments that may be effective in younger patients may be less effective in older adults for a variety of reasons, including: poor health literacy and lack of good communication with care providers; comorbid conditions that impact tolerance of medications; a higher rate of medication side effects and decreased efficacy of medications; poor inhaler technique; different asthma phenotypes that may not respond to conventional medications; and increased sensitivity to environmental factors such as air pollutants and indoor allergens.