Advances in the diagnosis and management of asthma in older adults

Mazen Al-Alawi, Hassan Tidi Maharani, Sanjay H. Chotirmall

Research output: Contribution to journalReview article

25 Citations (Scopus)

Abstract

Global estimates on aging predict an increased burden of asthma in the older population. Consequently, its recognition, diagnosis, and management in clinical practice require optimization. This review aims to provide an update for clinicians, highlighting advances in the understanding of the aging process and immunosenescence together with their applicability to asthma from a diagnostic and therapeutic perspective. Aging impacts airway responses and immune function, and influences efficacy of emerging phenotype-specific therapies when applied to the elderly patient. Differentiating eosinophilic and neutrophilic disease accounts for atopic illness and distinguishes long-standing from late-onset asthma. Therapeutic challenges in drug delivery, treatment adherence, and side-effect profiles persist in the older patient, while novel recording devices developed to aid detection of an adequate inhalation evaluate treatment effectiveness and compliance more accurately than previously attainable. Anticytokine therapies improve control of brittle asthma, while bronchial thermoplasty is an option in refractory cases. Multidimensional intervention strategies prove best in the management of asthma in the older adult, which remains a condition that is not rare but rarely diagnosed in this patient population.

Original languageEnglish
Pages (from-to)370-378
Number of pages9
JournalAmerican Journal of Medicine
Volume127
Issue number5
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Asthma
Therapeutics
Inhalation
Population
Compliance
Phenotype
Equipment and Supplies
Pharmaceutical Preparations

Keywords

  • Asthma
  • Diagnosis
  • Elderly
  • Older adult
  • Treatment

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Advances in the diagnosis and management of asthma in older adults. / Al-Alawi, Mazen; Tidi Maharani, Hassan; Chotirmall, Sanjay H.

In: American Journal of Medicine, Vol. 127, No. 5, 2014, p. 370-378.

Research output: Contribution to journalReview article

Al-Alawi, Mazen ; Tidi Maharani, Hassan ; Chotirmall, Sanjay H. / Advances in the diagnosis and management of asthma in older adults. In: American Journal of Medicine. 2014 ; Vol. 127, No. 5. pp. 370-378.
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