Asthma in older adults presents some special concerns.The normal effects of aging can make asthma harder to diagnose and treat. In addition, other health problems that older adults are more likely to have, including emphysema or heart disease, can make mask the symptoms of asthma.
Most persons with asthma have their first symptoms at a young age. But asthma may first appear at any age, even in a person's 70s or 80s. When asthma does develop at an advanced age, the symptoms are much like those among young adults. One way in which asthma differs at older ages, though, is that greater amounts of medication are needed to maintain normal breathing in older patients.
Asthma can be more dangerous in older adults because they are more likely to develop respiratory failure, even during mild attacks. Unlike the illness in younger persons, asthma in older adults rarely goes into remission. Rather, it is more likely to remain a severe and disabling disorder.
If you are an older adult, it is important that you work with your doctor to develop an asthma management plan to manage your symptoms and prepare for asthma attacks.
Treatment of Asthma in Older Adults
Treatment of asthma in older adults can be complicated by the fact that so many older persons take multiple medications for other health problems. Asthma medications can react with these other treatments, causing unpleasant side effects. In addition, other medications may worsen asthma symptoms.
Older patients are more likely than younger patients to have mental confusion and memory problems. This may be the result of normal aging or of an illness such as Alzheimer's disease. Whatever the cause, these problems can make it hard for an older patient to follow treatment instructions. This can be especially true if, like many older persons, the patient receives several types of medications for different health problems.
Many asthma medications come in the form of an inhaler. Using an inhaler requires a certain degree of coordination and dexterity. The patient must press down quickly on the inhaler while drawing in a short, deep breath. Older persons are more likely to have conditions such as arthritis, which affects physical movement and coordination. These patients may find it more difficult to use inhalers properly in order to receive the correct dose.
If you find it difficult to administer your asthma medication using an inhaler, you may choose to administer your medication using a device called a nebulizer. A nebulizer changes liquid medicine into fine droplets (in aerosol or mist form) that are inhaled through a mouthpiece or mask. Some people use a nebulizer instead of an inhaler to make asthma medication easier to inhale. Portable nebulizers, powered by an internal battery or cigarette lighter, are available for children requiring treatments away from home.
Treatment with oral medications can also help older asthma patients avoid problems with inhaler use. Short courses of oral steroids are helpful to treat acute asthma flares. Long-term oral steroid treatment is usually avoided in older asthma patients. Over time, oral steroids can cause severe side effects, such as weakening of bones, ulcers and high blood pressure.
Talk With Your Doctor
As with any asthma patient, treatment for older adults should be a joint decision between patient and doctor. Communication is the key to making treatment work. Older asthma patients should be sure to ask their doctor about any aspect of their asthma treatment that they do not understand. Keeping the doctor informed about how well treatment is working for them is important.
Patients need to tell their doctor if they are having trouble remembering to take their medication or if they are having difficulty using devices such as inhalers. Their doctor is an important resource to help them keep their asthma under control so that their later years are as comfortable and healthy as possible.
Source: National Heart, Lung & Blood Institute
Last updated : 9/10/2020