Significant predictors of poor quality of life in older asthmatics

Abstract

BackgroundMorbidity and mortality from asthma are high in older adults and quality of life (QOL) might be lower, although standardized measurements of QOL have not been validated in this population. ObjectiveTo determine predictors of asthma-related QOL in older adults. MethodsAllergy and pulmonary outpatients (n = 164) at least 65 years old with an objective diagnosis of asthma completed the Mini-Asthma Quality of Life Questionnaire (mAQLQ). Demographics, medical history, and mean value for daily elemental carbon attributable to traffic, a surrogate for diesel exposure, were obtained. Regression analysis was used to determine predictors of mAQLQ scores. ResultsTotal mAQLQ (mean ± SD 5.4 ± 1.1) and symptom, emotional, and activity domain scores were similar to those of younger populations, whereas environmental domain scores (4.4 ± 1.7) appeared lower. Poorer mAQLQ scores were significantly associated with emergency department visits (adjusted β [aβ] = −1.3, where β values indicate the strength and direction of association, P < .0001) and with poorer scores on the Asthma Control Questionnaire (aβ = −0.7, P < .0001). Greater ECAT exposure (aβ = −1.6, P < .02), female sex (aβ = −0.4, P < .006), body mass index of at least 30 kg/m2 (aβ = −0.4, P < .01), gastroesophageal reflux (aβ = −0.4, P < .01), nonatopic status (aβ = −0.5, P < .002), and asthma onset before 40 years of age (aβ = −0.5, P < .004) were significantly associated with poorer mAQLQ scores. ConclusionThe mAQLQ scores in older adults with stable asthma were similar to those in younger populations and were predictive of other measurements of asthma control, verifying that the mAQLQ is an appropriate tool in older adults with asthma. Traffic pollution exposure was the strongest predictor of poorer asthma-related QOL in older adults with asthma.