Bronchial Asthma in the Very Elderly

Abstract

Bronchial asthma (BA) is not rare in the elderly and causes significant morbidity and mortality. 1 Jack CI Lye M Asthma in the elderly patients. Gerontology. 1996; 42: 61-68 Crossref Scopus (22) Google Scholar 2 Enright PL McClelland RL Newman AB et al. Underdiagnosis and undertreatment of asthma in the elderly. Chest. 1999; 116: 603-613 Abstract Full Text Full Text PDF PubMed Scopus (311) Google Scholar BA beginning after the age of 50 years is more severe and less reversible than asthma in children. 3 Reed CE The natural history of asthma in adults: the problem of irreversibility. J Allergy Clin Immunol. 1999; 103: 539-547 Abstract Full Text Full Text PDF PubMed Scopus (134) Google Scholar We reviewed the clinical features and management of six patients ≥ 80 years old with BA diagnosed in our hospital over the past 10 years (mean age, 87 years; range, 80 to 97 years). Four patients had a history of cardiovascular disease, and one patient had a history of cerebrovascular disease. The bronchodilator inhalation test at ≥ 80 years of age resulted in a 16.0 to 43.2% (mean, 26.9%) increase in FEV1. Five patients received oral β2-agonists, and four patients received oral theophylline. At the time of exacerbation of BA in one patient, theophylline was administrated IV and the serum theophylline level was temporarily elevated to the toxic range. This toxicity might be due to the simultaneous administration of oral quinolone antibiotics. Five patients received inhaled steroids; however, in one patient steroid inhaler was not prescribed because of poor adherence to aerosol because of its odor.