Aging with asthma

Zoomer | January 1st, 2006

Deep hacking coughs and an inability to get a breath-two million Canadians recognize these asthma symptoms. For Canadians over 65, age can compound diagnosis and treatment. And the number of asthma cases is rising-by two per cent in the past 20 years. Overall, this chronic lung disease now affects six per cent of the population.

About 80 per cent of all asthma cases develop in childhood. But it’s also possible to get it for the first time as an adult. Late-onset asthma, as it’s called, typically strikes in the late 40s or early 50s, very often after a bout of influenza. There are differences between the two types of asthma.

  • About 80 per cent of childhood asthma is associated with allergies.
That means allergens such as dust mites or cat dander cause an allergic reaction that increases inflammation in the lungs that can set off an asthma attack.
  • In late-onset asthma, only about half the cases are related to allergies.
The other half is non-allergic. The patient doesn’t have an allergy, but still can have an attack when exposed to elements such as cold air or smoke.

Non-allergic asthma is a bit of a mystery. Some cases are e result of a condition called acid reflux. Acid from the stomach makes its way up the throat and gets sucked down into the lungs where it causes inflammation. But what causes many other cases of non-allergic asthma is not well understood.

Age complications
Asthma can also come back if you had it as a child. It’s not uncommon to get over asthma symptoms in adolescence only to have them return 30 or 40 years later. Yet there’s also a chance adult asthma will disappear. As people get older, about a third of the cases get better, a third get worse and a third stay the same.

Age can also complicate the diagnosis and treatment of allergic diseases. Allergic asthma, for example, can be mistaken for bronchitis, emphysema or lung congestion caused by heart problems. A thorough exam, usually including a chest X-ray, can sort it out.

Senior patients may not always respond to treatment as well as younger ones. Some asthma medications don’t mix with medicines more commonly used by senior adults. And while the effects of asthma are usually reversible, patients who’ve had asthma all their lives and have not been properly treated – an all too common situation – can suffer long-term damage. There can be permanent obstructions caused by scarring from a lifetime of frequent inflammation.

Senior adults might also feel the effects of asthma more acutely because the elastic recoil of the lungs – the springiness that holds the lungs open – drops off as people age, reducing lung capacity and making it even harder for people with asthma to breathe.