Abstract
S U N D A Y 567 Asthma in Cincinnati's Elderly Study: Significant Impact of Asthma on Psychosocial Function A. M. Smith, E. T. Stanforth, M. Villareal, D. J. Swikert, D. I. Bernstein; University of Cincinnati Medical Center, Cincinnati, OH, Cincinnati VA Medical Center, Cincinnati, OH, St. Elizabeth Medical Center, Edgewood, KY. RATIONALE: Asthma in older adults is underdiagnosed and undertreated, resulting in suboptimal asthma control and potential psychosocial effects. The objective of this study is to evaluate factors affecting psychosocial functioning in older asthmatics. METHODS: Asthmatic and non-asthmatic patients >_60 years old (n577) were recruited from the general population. A medical history, physical exam, skin prick testing, and spirometry were performed. Psychosocial function (daily activity, social characteristics, and mental health symptoms [MHS]) was assessed through the standardized OARS questionnaire and analyzed using chi-square, t-test, and logistic regression. RESULTS: Mean age was 68.767.2 years; 59 (77%) were female. Mean percent predicted FEV1 at baselinewas lower in asthmatics (73.7621.6%) than controls (90.0619.1%) (p50.0008). The univariate analysis showed the asthma group had worse daily functioning, decreased activity levels, and impaired social support [SS] (p < 0.05). After adjusting for gender, race, and comorbidities, physical impairment (Adjusted Odds Ratio [aOR]: 9.7; 95% CI: 3.1-30.8; p50.0001) and impaired SS (aOR: 5.1; 95% CI: 1.5-17.2; p50.0001) were independently related to asthma. No significant differences were found in social interactions/resources or reported MHS. While impaired activity was associated with decreased pulmonary function (p50.004), impaired SS was not (p50.5). Those with impaired SS reported significantly increased desire for psychological counseling (p50.02). CONCLUSIONS: Older adults with asthma have significantly impaired psychosocial functioning, specifically daily activity levels and social support, independent of MHS and social interactions/resources. Treating asthma can improve pulmonary function and potentially reduce physical impairment, but improving levels of social support may require social service or psychological interventions.
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