Questionnaire-based characterization of bronchial asthma in the elderly: Analysis in Niigata Prefecture, Japan

Abstract

ABSTRACT Background Because the mean lifespan is increasing and the percentage of elderly people among the population as a whole is also increasing, the management of elderly bronchial asthma patients will be an important issue in medicine in the future. In the present study, based on questionnaires given to 3224 asthmatic patients in Niigata Prefecture, the characteristics, management and circumstances of elderly asthmatic patients were investigated. Methods Questionnaires were completed by asthmatic patients and their physicians in participating institutions within Niigata Prefecture from September to October 1999. Patients more than 65 years of age were defined as elderly asthmatic patients and a comparison was made between these patients and younger asthmatic patients who were less than 64 years of age and were used as a control group. Results In the classification of bronchial asthma, a greater frequency of infectious and mixed-type bronchial asthma was found in the elderly, whereas the use of peak flow meters was lower in this group. Significant differences were found for both self- evaluation of the condition of the asthma and satisfaction with daily life between the two age groups. A lower incidence of ambulance use, emergency room visits and use of inhaled steroids was observed in elderly patients, although the incidence of hospitalization and use of oral steroids was higher. The discrepancy between objective and subjective evaluation of asthma control, the incidence of the use of both inhaled and oral steroids and the low use of peak flow meters were problematic in the elderly. Conclusions Based on sufficient consideration of the problems specifically related to elderly asthmatic patients, adequate education and careful management of asthma in this group are required, and the accumulation of these steps will result in the achievement of the guidelines final goals.