The Predictors of Elderly Asthma Control

Abstract

The GINA guideline emphasizes the importance of achieving controlled state of asthma. We conducted this study to evaluate asthma control state in the elderly and predict factors related with poor control. A retrospective observational study evaluating 108 elderly asthmatics was done from October 2010 to March 2011. Subjects were classified into two: group I consisted of 38 patients with ACT≤19, group II included 70 patients with ACT>20. Spirometry, sputum eosinophil count and questionnaire survey (ACT and AQOL) were performed. Medication possession ratio(MPR) was calculated to evaluate compliance. The prevalence of severe asthma, aspirin intolerance, occupational asthma and atopy were 21.3%, 13.0%, 4.6% and 47.2%. The prevalence of co-morbid conditions was found in more than 50% of the patients in which allergic rhinitis was the most common followed by cardiovascular disease and degenerative arthritis. The 35.2% of patients were in poorly controlled state with significantly lower AQOL score and higher admission rate (p< 0.05 respectively). The prevalence of history with old pulmonary tuberculosis(TB) and admission for asthma showed significant differences between group I and II (31.6% vs 12.9%, 21.1% vs 7.1%, p <0.05 for both). Multivariate logistic regression analysis showed that history of TB was a significant predictor for poorly-controlled state (OR 4.61, CI 1.08-19.63, p value =0.039). The history of TB may contribute to the poorly-controlled state in elderly.