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The impact of aging on outpatients with asthma in a real-world setting

Giorgio Ciprandi, Irene Schiavetti, and Fabio LM Ricciardolo
Respir Med 2018; 136:58-64.
doi: 10.1016/j.rmed.2018.01.018

Biomechanical factors cause a decline in lung function in older patients. However, less is known about the clinical and functional impacts of ageing on patients with asthma. Giorgio Ciprandi and colleagues from Genoa and Turin, Italy, sought to evaluate how several clinical parameters differed between asthmatic patients in different age groups.

A total of 391 adult patients presenting at a specialist asthma clinic were enrolled, of whom elderly asthmatics (aged >65 years) made up approximately 25%. The study findings confirmed the association between age and decreased lung function, with significant differences observed for older patients in most of the clinical and functional variables analysed. Forced expiratory volume in 1 second (FEV1) as a percentage of predicted was significantly lower in elderly patients compared with both adult (41-64 years) and young adult (18-40 years) groups. This pattern of decreasing values with increasing age was also true for forced vital capacity (FVC) as a percentage of predicted and for the FEV1/FVC ratio. Asthma control (defined by the Asthma Control Test) was also generally worse in older patients, while BMI and average doses of inhaled corticosteroids (ICS) were higher.

Conversely, the opposite effect was seen for allergy and rhinitis. Across the whole population, approximately 80% of patients had at least one allergy, and 89.8% had rhinitis as a comorbidity. However, adult patients were three times more likely to have allergies than the elderly group, and young adults were eight times more likely. The paper therefore concluded that older patients with asthma are more likely to have reduced lung function, higher BMI and higher ICS doses, but less likely to have comorbid allergy or rhinitis, than their younger counterparts.

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