What Are the Signs and Dangers of Asthma in the Elderly?

Asthma is a chronic lung disease that causes the airways to become inflamed and makes breathing difficult. Asthma can affect people of all ages, but it is most prevalent in people under 40. When it involves the elderly, it can be pretty severe and challenging to manage.

The bronchial tubes constrict during an asthma episode, and the airway muscles tighten, obstructing airflow through the lungs. An attack is characterized by cough, increased mucus production, breathlessness, chest tightness, fatigue, panic and wheezing. The symptoms can range from mild to severe and may be life-threatening in some cases.

Asthma is diagnosed by a physical examination of symptoms, asthma tests like spirometry, a challenge test that involves exposure to cold air or exercise, or a skin prick to detect specific allergies. Asthma is treated using drugs, medical devices and adopting lifestyle changes aimed at avoiding triggers.

Asthma in Seniors

Asthma in the elderly often coexists with other conditions like Chronic Obstructive Pulmonary Disorder (COPD), obesity, and low immunity making it harder to detect and treat. The symptoms of asthma may also mirror the natural effects of aging. Diminished lung function, weakened respiratory muscles, and heart or kidney disease can contribute to asthma in seniors.

About four to 13 percent of individuals in the US aged 65 and above have asthma, with the figure expected to almost triple by 2050. Members of this age group are more than five times likely to die from the disease than younger individuals. Some older adults develop asthma later in life, while others have it as a continuing problem from their younger years.

Seniors can control asthma by avoiding environmental triggers, but many cannot adopt the lifestyle changes required to handle the condition.

Asthma treatments include bronchodilators to expand the airways for easy breathing and inhaled corticosteroid drugs to inhibit inflammation. The side effects of asthma medication are more prominent in older adults, and it often takes longer to recover from an episode. Seniors will have to adopt other lifestyle changes to stay healthy and active as they manage the condition.

Causes of Asthma

The exact cause of asthma is unknown. The suggested causes of the disease are largely the same among various age groups.

A weakened immune system in older adults may make them more vulnerable to asthma. Hypersensitive airways tighten and become clogged when exposed to specific triggers.

People at higher risk of developing asthma as seniors include:

• People with a family history of the disease or an atopic condition – any condition that makes the immune system more sensitive to allergens

• Having asthma as a younger individual

• A history of bronchiolitis – a lower respiratory tract infection that affects infants below two years of age

• Hygiene hypothesis – inadequate exposure to bacteria as a baby, so the immune system is not strengthened enough to withstand allergic triggers

• Smoking or prolonged exposure to tobacco smoke as a child

• Occupational asthma resulting from working with wood dust, latex, spray paint, grain dust, and other such allergens

The most common triggers of asthma attacks include

• Infections such as flu and cold
• Changing weather conditions
• Exercise or strenuous physical activity
• Allergens – pollen, dust mites, feathers, or animal dander
• Certain drugs like painkillers and anti-inflammatory medications
• A moldy or damp environment
• Stressful situations and emotional or mental triggers

Managing Asthma in the Elderly

Drug Treatment

There are four categories of medications for treating asthma. These drugs are prescribed based on the type of asthma, age, and specific triggers.

Quick-relief Drugs

Quick-relief drugs are used for asthma attacks. These inhalers are rescue drugs that act fast to control symptoms by opening the airways and relaxing bronchial muscles. Examples include Albuterol (Ventolin HFA, Proventil HFA, ProAir HFA), Levalbuterol (Xopenex HFA), and Terbutaline.

Long-term Control Drugs

These drugs are taken regularly or as needed to reduce sensitivity to allergies and control persistent asthmatic attacks. Examples include Symbicort (Vannair), Flovent, Advair, and Pulmicort.

Combination of Quick-relief and Long-term Control Drugs

This class of drugs helps the patient achieve short-term relief and long-term control of symptoms. The Food and Drug Administration has not approved these drugs for treatment, even though current asthma clinical guidelines recommend them.

Biologics

Biologics are taken with control medications to stop underlying responses that cause the lungs to become inflamed. They target specific antibodies and disrupt the pathway that leads to inflammation. Biologics are administered as infusions or injections.

Other steps elderly patients can take in managing asthma include:

Monitoring Symptoms

Keeping a journal of symptoms makes it easy for older patients to detect changes or in their health. Patients should also note when and where the symptoms started, what they were doing, and what may have triggered the symptoms. Regular peak flow measurements also help to monitor asthma symptoms. They should act quickly or contact their doctor if the symptoms get severe.

Using the Proper Inhaler Technique

Asthma patients, especially seniors, should check their inhaler technique regularly to ensure they are doing it right. Patients who have trouble using their inhalers due to an ailment like arthritis should request an easier device.

Seeking Treatment for Other Conditions

Asthma in the elderly frequently overlaps with other conditions like acid reflux and COPD, worsening symptoms. Patients should speak with their healthcare provider about treatments for this condition.

Lifestyle Adjustments for Older Adults with Asthma

Elderly patients with asthma can improve their symptoms and overall health by making certain lifestyle modifications:

Staying Active

Older patients are more likely than not to adopt a sedentary lifestyle because of age-related health conditions. A non-active lifestyle can be risky for older patients with asthma. Patients should work with their doctors to devise a workout plan that considers their lung function.

Smoking Cessation

Seniors who smoke and have asthma are often not as motivated to give up smoking. Quitting smoking lowers the risk of attacks and helps medications to work better.

Mental Health Checks

Mental health issues like anxiety and depression can trigger or worsen symptoms. Seeing a therapist and building a support network of friends and family can help patients reduce their symptoms.

Conclusion

Asthma should not prevent anyone from enjoying their retirement years. Working with a healthcare provider to devise a suitable asthma action plan can help seniors with asthma to have a good quality of life.