Asthma in the elderly is a disease with emerging concern. Despite some recent advances in our understanding of epidemiology and pathophysiology, there is a considerable lack of clinical evidence specific to elderly patients. Currently available high quality clinical evidence has been mostly obtained from younger adults, but rarely from elderly patients. Under-representation of elderly patients in previous randomized trials may have been due to being, old age, or having comorbidities. Thus, a question may be raised whether current clinical evidence could be well generalized into elderly patients. Further clinical trials should address clinical issues raised in elderly population. In this review, we aimed to overview the efficacy and safety of pharmacological management, and also to summarize the literature relevant to elderly asthma.
Adult ; Aged ; Asthma ; Comorbidity ; Drug Therapy ; Epidemiology ; Humans

Asthma ; epidemiology ; prevention & control ; therapy ; Child ; China ; epidemiology ; Drug Therapy, Combination ; Humans ; Immunotherapy

Asthma ; drug therapy ; epidemiology ; physiopathology ; prevention & control ; Humans ; Pediatrics ; Singapore ; epidemiology

The prevalence of asthma is approximately 5% to 10% in the general population. Of these, approximately 5% to 10% are severe asthmatics who respond poorly to asthmatic drugs, including high-dose inhaled steroids. Severe asthmatics have persistent symptoms, frequent symptom exacerbation, and severe airway obstruction even when taking high-dose inhaled steroids. The medical costs of treating severe asthmatics represent ~50% of the total healthcare costs for asthma. Risk factors for severe asthma are genetic and environmental, including many kinds of aeroallergens, beta-blockers, and anti-inflammatory drugs. Gastroesophageal reflux disease and factors such as denial, anxiety, fear, depression, socioeconomic status, and alcohol consumption can exacerbate asthma. Rhinitis and asthma usually occur together. There is increasing evidence that allergic rhinitis and rhinosinusitis may influence the clinical course of asthma. This review discusses the role of rhinosinusitis in severe asthma.
Asthma/diagnosis/drug therapy/*epidemiology ; Comorbidity ; Humans ; Prognosis ; Rhinitis/diagnosis/drug therapy/*epidemiology ; Risk Factors ; Severity of Illness Index ; Sinusitis/diagnosis/drug therapy/*epidemiology

Asthma ; drug therapy ; epidemiology ; pathology ; China ; Humans ; Pleural Diseases ; drug therapy ; epidemiology ; pathology ; Pulmonary Medicine ; methods ; Severe Acute Respiratory Syndrome ; drug therapy ; epidemiology ; pathology

Asthma ; drug therapy ; mortality ; Cost of Illness ; Humans ; Patient Admission ; trends ; Singapore ; epidemiology

Asthma ; drug therapy ; epidemiology ; etiology ; China ; epidemiology ; Cluster Analysis ; Humans ; Phenotype ; Pulmonary Eosinophilia ; etiology ; Smoking ; adverse effects ; Th2 Cells ; immunology

OBJECTIVETo investigate the prevalence of childhood asthma, and to find the distribution characteristics, precipitating factors, diagnosis and treatment status, and to provide scientific data for improving the prevention and management of asthma in children in Kunming City, China.

METHODSChildren were selected by random cluster sampling. A standardized preliminary questionnaire was used for screening out possible patients in the survey. Diagnosis of asthma was confirmed by diagnostic criteria in suspected asthmatic children. Asthmatic children were further asked for past diagnosis and treatment with the questionnaire of asthma in children.

RESULTSThe total asthma incidence rate was 1.40%. The prevalence of asthma in male and female children was 1.89% and 0.88% respectively (P<0.05). Children aged 0-5 years old had a higher prevalence of asthma (1.69%) than that of school-age children (6-14 years old, 1.21%). In all asthmatic children, 51.3% were previously diagnosed with classical asthma or cough variant asthma, 26.0% were suffered attacks from December to February, and 54.0% were suffered attacks at midnight or dawn. Respiratory tract infection (87.3%) was the most common triggers of asthma exacerbation. Antibiotics were used in 80.0%, bronchodilators in 66.0%, inhaled corticosteroid in 64.0%. A peak flow meter for monitoring lung function was used in 17% of asthmatic children over 5 years old.

CONCLUSIONSThe prevalence of asthma is associated with age and gender in children aged 0-14 years old in Kunming City. Acute asthma attack occurs mostly in winter and at midnight or dawn. Respiratory tract infection is the most common trigger of asthma exacerbation. Nearly a half of patients with asthma had not been diagnosed with asthma in the early stage. Most asthmatic children use antibiotics and only two-thirds use bronchodilators or inhaled corticosteroid in the treatment. The treatment and management of asthma in children awaits improvement as well.

Adolescent ; Asthma ; drug therapy ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Prevalence ; Seasons

OBJECTIVETo investigate the cumulative prevalence rate, distribution characteristics, epidemic seasons, predisposing factors and current treatment situation of childhood asthma in Hefei City, China.

METHODSIn the investigation, stratified cluster random sampling as well as centralized access and separate home visits were applied, and primary screening forms were filled out. Further confirmation was sought in the primary positive cases, according to the diagnostic criteria for asthma. Statistical analysis was performed to determine the cumulative prevalence rate, current treatment situation and predisposing factors for childhood asthma as well as the distribution characteristics of asthma in children of different ages and sexes.

RESULTSThe cumulative prevalence rate of childhood asthma was 5.92%, and there was no significant difference between males and females (6.33% vs 5.42%; P>0.05). The cumulative prevalence rate was highest (8.25%) in children aged 3-6 years. Of the children with acute asthma attack, 42.0% suffered attacks during periods of seasonal transition, and 34.4% suffered attacks at midnight. Among the 552 children with a confirmed diagnosis of asthma, 533 (96.6%) developed asthma due to respiratory tract infection and 312 (56.5%) due to weather change. Most asthmatic children (513/552, 92.9%) received treatment with antibiotics, and 492 asthmatic children (89.1%) were treated with systemic hormones.

CONCLUSIONSThe cumulative prevalence rate of childhood asthma is 5.92% in Hefei, and the peak age of onset is 3-6 years. Acute asthma attack occurs mostly during periods of seasonal transition and at midnight. Respiratory tract infection and weather change are the main predisposing factors for childhood asthma. Antibiotics and systemic hormones are still widely used in the treatment of asthma.

Adolescent ; Asthma ; drug therapy ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male

OBJECTIVETo investigate the prevalence and incidence of asthma among children aged 0-14 years, with different living environments, economic levels, and sanitary conditions, in the urban and rural areas of Chengdu, China, and their influential factors.

METHODSChildren aged 0-14 years who were selected from urban, suburban and rural areas of Chengdu, were included in the study. The subjects were selected from all children aged 0-14 years in schools, kindergartens and communities by random, cluster and non-proportional sampling. Parents were surveyed by questionnaire to find out suspected cases, which were then confirmed by inquiry and physical examination in the department of respiratory medicine. All the obtained data were analyzed using SPSS/PC statistical software.

RESULTSA total of 12082 children from the urban areas, 5677 from suburban areas and 5590 from the rural areas were included in the study. Of all the subjects, 551 (4.56%) had confirmed asthma, 150 (2.64%) had cough variant asthma (CVA), and 142 (2.54%) had suspected asthma. The prevalence rate of asthma was significantly higher in the urban areas than in the suburban and rural areas. The correct rate of diagnosis of asthma and CVA was highest in the urban areas, followed by the suburban and rural areas. Use of antibiotics and systemic corticosteroids was most common in the rural areas, followed by the suburban and urban areas, but this pattern was reversed for use of inhaled corticosteroids and leukotriene modifier. All the results in the three areas demonstrated that sex, age, age at which the first attack occurred, respiratory tract infection, inhalation/intake of allergens and genetic factors were significantly associated with asthmatic attack.

CONCLUSIONSPopulation density, living environment, medical and health resources and economic level are associated with the prevalence and treatment of asthma.

Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; Asthma ; drug therapy ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Seasons