A clinical comparison between early-onset and late-onset asthma in the elderly

Choi, Inseon S; Myung, Bo Hyun; Kang, Kwang Won

Abstract

BACKGROUND
The asthma mortality has risen during last decades, especially in the elderly. This study was performed to investigate whether newly-developed asthma in the elderly has any difference in clinical features relating to asthma severity compared to early-onset asthma (EOA).
METHODS
Thirty-three asthma patients (> or = 60 years-old) hospitalized due to severe attack were classified to late-onset (LOA) when their asthma developed after the age of 60 and the remaining to EOA. Data obtained from their medical records were analyzed retrospectively.
RESULTS
Ten out of the 33 patients (30.3%) were LOA. Duration of asthma was significantly longer in EOA (21.6+/-14.8 years vs. 2.9+/-2.4 years, p<0.001). There were no significant differences between both groups in age, sex, atopy history (personal and familial), sinusitis, and peripheral blood eosinophils. However, EOA showed more smoking history and frequent exacerbations following URI-like symptoms (p<0.05, respectively), and higher serum total IgE level (geographic mean: 228 vs. 20 IU/mL, p<0.001). Life-threatening asthma attack was developed more frequently (89.5% vs. 40%, p<0.05), and the lung function measurements obtained just before discharge were significantly lower (FEV1/FVC: 54.8+/-10.1% vs. 64.6+/-11.7%, p<0.05) in EOA. Severity of chronic asthma was significantly more severe in EOA (moderate to severe persistent asthma: 95.6% vs. 60.0%, p<0.05).
CONCLUSION
Many elderly asthmatics develop asthma newly in their old age. EOA is more related to atopic allergy, and seems to have more severe and long-standing asthma leading to chronic persistent airflow obstruction.