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Challenges in the Management of Asthma in the Elderly.

Song WJ, Cho SH - Allergy Asthma Immunol Res (2015)

Bottom Line: However, why the disease burden remains high in this group is unclear.Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated.In addition, we discuss patient management issues.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT
Recent literature has emphasized the clinical and socio-epidemiological significance of asthma in the elderly. However, why the disease burden remains high in this group is unclear. Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated. This review aims to summarize the literature associations between comorbidities and asthma in elderly patients. In addition, we discuss patient management issues.

No MeSH data available.


Related in: MedlinePlus

Schematic presentation for the epidemiology of asthma in the elderly. Lines indicate the aged-related changes in the prevalence; gray line, childhood-onset asthma; blue line, airway hyperresponsiveness; and red line, late-onset adult asthma. Adult asthma prevalence was depicted based on previous publications.2531AHR, airway hyperresponsiveness; SE-IgE, staphylococcal enterotoxin IgE.
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Figure 1: Schematic presentation for the epidemiology of asthma in the elderly. Lines indicate the aged-related changes in the prevalence; gray line, childhood-onset asthma; blue line, airway hyperresponsiveness; and red line, late-onset adult asthma. Adult asthma prevalence was depicted based on previous publications.2531AHR, airway hyperresponsiveness; SE-IgE, staphylococcal enterotoxin IgE.

Mentions: Such cross-sectional studies have rarely examined the age of asthma onset and afford little information on late-onset asthma in the elderly. Thus, herein, we rely largely on reports on adult-onset asthma, and we speculate that the data may be extrapolated to older adults (Fig. 1). The European Community Respiratory Health Survey (ECRHS) is one of the largest population surveys on adult asthma conducted to date, and longitudinal follow-up has revealed that rhinitis is a strong predictor of asthma during adulthood, irrespective of atopic status.33 This finding has been supported by another recent European population survey, the Global Allergy and Asthma Network of Excellence (GA2LEN) study, which found a strong association between chronic rhinosinusitis (CRS) and adult-onset asthma, irrespective of nasal allergy status.34 Regarding this, immune responses to SE may be involved in the relationship3132; Staphylococcus aureus frequently colonizes the human nasal mucosa, and the enterotoxins thereof may provoke CRS and nasal polyp development.35 We suppose that SE-IgE is either a biomarker of CRS and asthma, or an active mediator in the relationships between upper and lower airway disease.


Challenges in the Management of Asthma in the Elderly.

Song WJ, Cho SH - Allergy Asthma Immunol Res (2015)

Schematic presentation for the epidemiology of asthma in the elderly. Lines indicate the aged-related changes in the prevalence; gray line, childhood-onset asthma; blue line, airway hyperresponsiveness; and red line, late-onset adult asthma. Adult asthma prevalence was depicted based on previous publications.2531AHR, airway hyperresponsiveness; SE-IgE, staphylococcal enterotoxin IgE.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4509655&req=5

Figure 1: Schematic presentation for the epidemiology of asthma in the elderly. Lines indicate the aged-related changes in the prevalence; gray line, childhood-onset asthma; blue line, airway hyperresponsiveness; and red line, late-onset adult asthma. Adult asthma prevalence was depicted based on previous publications.2531AHR, airway hyperresponsiveness; SE-IgE, staphylococcal enterotoxin IgE.
Mentions: Such cross-sectional studies have rarely examined the age of asthma onset and afford little information on late-onset asthma in the elderly. Thus, herein, we rely largely on reports on adult-onset asthma, and we speculate that the data may be extrapolated to older adults (Fig. 1). The European Community Respiratory Health Survey (ECRHS) is one of the largest population surveys on adult asthma conducted to date, and longitudinal follow-up has revealed that rhinitis is a strong predictor of asthma during adulthood, irrespective of atopic status.33 This finding has been supported by another recent European population survey, the Global Allergy and Asthma Network of Excellence (GA2LEN) study, which found a strong association between chronic rhinosinusitis (CRS) and adult-onset asthma, irrespective of nasal allergy status.34 Regarding this, immune responses to SE may be involved in the relationship3132; Staphylococcus aureus frequently colonizes the human nasal mucosa, and the enterotoxins thereof may provoke CRS and nasal polyp development.35 We suppose that SE-IgE is either a biomarker of CRS and asthma, or an active mediator in the relationships between upper and lower airway disease.

Bottom Line: However, why the disease burden remains high in this group is unclear.Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated.In addition, we discuss patient management issues.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.; Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.

ABSTRACT
Recent literature has emphasized the clinical and socio-epidemiological significance of asthma in the elderly. However, why the disease burden remains high in this group is unclear. Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated. This review aims to summarize the literature associations between comorbidities and asthma in elderly patients. In addition, we discuss patient management issues.

No MeSH data available.


Related in: MedlinePlus