A clinical comparison between early-onset and late-onset asthma in the elderly.
- Author:
Inseon S CHOI
1
;
Bo Hyun MYUNG
;
Kwang Won KANG
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School and Chonnam Research Institutes of Medical Sciences, Kwangju, Korea.
- Publication Type:Original Article
- Keywords:
Asthma;
Elderly;
Early-onset;
Late-onset;
Severity
- MeSH:
Aged*;
Asthma*;
Eosinophils;
Humans;
Hypersensitivity;
Immunoglobulin E;
Loa;
Lung;
Medical Records;
Mortality;
Retrospective Studies;
Sinusitis;
Smoke;
Smoking
- From:Korean Journal of Medicine
2001;61(6):616-622
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The asthma mortality has risen during last decades, especially in the elderly. This study was performed to investigate whether newly-developed asthma in the elderly has any difference in clinical features relating to asthma severity compared to early-onset asthma (EOA). METHODS: Thirty-three asthma patients (> or = 60 years-old) hospitalized due to severe attack were classified to late-onset (LOA) when their asthma developed after the age of 60 and the remaining to EOA. Data obtained from their medical records were analyzed retrospectively. RESULTS: Ten out of the 33 patients (30.3%) were LOA. Duration of asthma was significantly longer in EOA (21.6+/-14.8 years vs. 2.9+/-2.4 years, p<0.001). There were no significant differences between both groups in age, sex, atopy history (personal and familial), sinusitis, and peripheral blood eosinophils. However, EOA showed more smoking history and frequent exacerbations following URI-like symptoms (p<0.05, respectively), and higher serum total IgE level (geographic mean: 228 vs. 20 IU/mL, p<0.001). Life-threatening asthma attack was developed more frequently (89.5% vs. 40%, p<0.05), and the lung function measurements obtained just before discharge were significantly lower (FEV1/FVC: 54.8+/-10.1% vs. 64.6+/-11.7%, p<0.05) in EOA. Severity of chronic asthma was significantly more severe in EOA (moderate to severe persistent asthma: 95.6% vs. 60.0%, p<0.05). CONCLUSION: Many elderly asthmatics develop asthma newly in their old age. EOA is more related to atopic allergy, and seems to have more severe and long-standing asthma leading to chronic persistent airflow obstruction.
