Background: The exponential increase of individuals aged >64 yrs is expected to impact the burden of asthma. We aimed to explore the level of asthma control in elderly subjects, and factors influencing it. Methods: A multicenter observational study was performed on consecutive patients >64 years old with a documented physician-diagnosis of asthma. Sixteen Italian centers were involved in this 6-month project. Findings: A total of 350 patients were enrolled in the study. More than one-third of elderly asthmatic patients, despite receiving GINA step 3-4 antiasthmatic therapy, had an Asthma Control Test score ≤ 19, with a quarter experiencing at least one severe asthma exacerbation in the previous year. Twenty-nine percent of patients (n Z 101) were classified as having Asthma-COPD Overlap Syndrome (ACOS) due to the presence of chronic bronchitis and/or CO lung diffusion impairment. This subgroup of patients had lower mean Asthma Control Test scores and more exacerbations compared to the asthmatic patients (18 ± 4 compared to 20 ± 4, p < 0.01, and 43% compared to 18%, p < 0.01, respectively). Modified Medical Research Council dyspnea mMRC scores and airway obstruction, assessed on the basis of a FEV1/FVC ratio below the lower limit of normal, were more severe in ACOS than in asthma, without any difference in responses to salbutamol. In a multivariate analysis, the mMRC dyspnea score, FEV1% of predicted and the coexistence of COPD were the only variables to enter the model. Interpretation: Our results highlight the need to specifically evaluate the coexistence of features of COPD in elderly asthmatics, a factor that worsens asthma control.

Asthma control in elderly asthmatics. An italian observational study / M., Milanese; F., Di Marco; Corsico, A. G.; G., Rolla; B., Sposato; F., Chieco Bianchi; Costantino, M. T.; Ma, Crivellaro; G., Guarnieri; N., Scichilone; F., Agusta; M., Caminati; G., Liccardi; C., Lombardi; M., Marchi; E., Mereu; G., Passalacqua; F., Reccardini; Ridolo, Erminia; G., Senna; G., Steinhilber; A., Vianello. - In: RESPIRATORY MEDICINE. - ISSN 0954-6111. - (2014), pp. 1091-1099. [10.1016/j.rmed.2014.05.016]

Asthma control in elderly asthmatics. An italian observational study.

RIDOLO, Erminia;
2014-01-01

Abstract

Background: The exponential increase of individuals aged >64 yrs is expected to impact the burden of asthma. We aimed to explore the level of asthma control in elderly subjects, and factors influencing it. Methods: A multicenter observational study was performed on consecutive patients >64 years old with a documented physician-diagnosis of asthma. Sixteen Italian centers were involved in this 6-month project. Findings: A total of 350 patients were enrolled in the study. More than one-third of elderly asthmatic patients, despite receiving GINA step 3-4 antiasthmatic therapy, had an Asthma Control Test score ≤ 19, with a quarter experiencing at least one severe asthma exacerbation in the previous year. Twenty-nine percent of patients (n Z 101) were classified as having Asthma-COPD Overlap Syndrome (ACOS) due to the presence of chronic bronchitis and/or CO lung diffusion impairment. This subgroup of patients had lower mean Asthma Control Test scores and more exacerbations compared to the asthmatic patients (18 ± 4 compared to 20 ± 4, p < 0.01, and 43% compared to 18%, p < 0.01, respectively). Modified Medical Research Council dyspnea mMRC scores and airway obstruction, assessed on the basis of a FEV1/FVC ratio below the lower limit of normal, were more severe in ACOS than in asthma, without any difference in responses to salbutamol. In a multivariate analysis, the mMRC dyspnea score, FEV1% of predicted and the coexistence of COPD were the only variables to enter the model. Interpretation: Our results highlight the need to specifically evaluate the coexistence of features of COPD in elderly asthmatics, a factor that worsens asthma control.
2014
Asthma control in elderly asthmatics. An italian observational study / M., Milanese; F., Di Marco; Corsico, A. G.; G., Rolla; B., Sposato; F., Chieco Bianchi; Costantino, M. T.; Ma, Crivellaro; G., Guarnieri; N., Scichilone; F., Agusta; M., Caminati; G., Liccardi; C., Lombardi; M., Marchi; E., Mereu; G., Passalacqua; F., Reccardini; Ridolo, Erminia; G., Senna; G., Steinhilber; A., Vianello. - In: RESPIRATORY MEDICINE. - ISSN 0954-6111. - (2014), pp. 1091-1099. [10.1016/j.rmed.2014.05.016]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2775532
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