Asthma in Older Adults

What is asthma?

Asthma is a long-term disease of the airways of the lungs. It's often diagnosed in children. But you can get asthma as an older adult even if you’ve never had it before.

Asthma in older adults may be harder to diagnose. It can be hard to tell asthma from other conditions that are more common in older adults. These include heart failure and chronic obstructive pulmonary disease (COPD). These diseases may cause symptoms that are like asthma, such as wheezing.

Asthma makes the airways sensitive to triggers (allergens and irritants). When a person with asthma is around such triggers, these changes happen:

• The lining of the airways becomes swollen and inflamed.

• The muscles around the airways tighten.

• More mucus is made.

All these factors cause the airways to narrow. This makes it hard for air to go in and out of the lungs.

What causes asthma in older adults?

The exact cause of asthma at any age is not known. It's believed to be partly inherited. The environment, infections, and chemicals released by the body may also be involved. These are possible asthma triggers:

• Allergens, such as pollen, mold, dust, and pet dander

• Irritants, such as chemicals, air pollution, and tobacco smoke

• Infections, such as a cold or sinus infection

• Some medicines, such as aspirin or those used to treat high blood pressure

• Other health problems, such as obesity and gastroesophageal reflux disease (GERD or heartburn)

• Exercise

• Stress or strong emotions

• Hormonal changes, such as during pregnancy or menopause

What are the symptoms of asthma in older adults?

The symptoms of asthma are the same at any age. They are:

• Coughing, especially at night

• Wheezing

• Having chest tightness

• Feeling short of breath

• Breathing faster than normal

• Getting out of breath easily

• Feeling tired or weak

These symptoms can be from other lung problems, heart problems, or infections. They can also be symptoms of many other conditions. Talk with your healthcare provider about your symptoms.

How is asthma in older adults diagnosed?

It’s important to know for sure that you have asthma. That’s because the treatment of asthma and other diseases, such as COPD, is very different. Your provider will first ask you about your symptoms and past health. They will also do a physical exam. You may also need some tests.

An important test for diagnosing and monitoring asthma is spirometry. A spirometer is a device that is used to gauge how well the lungs are working. It measures the amount and speed of air exhaled. Other tests may also be done to check for conditions, such as allergies.

How is asthma in older adults treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

There is no known cure for asthma. But you can take steps to control it:

• Know and stay away from your asthma triggers. These may include things, such as pollen, dander, smoke, and stress.

• Take your prescribed medicines. You may need to take medicines by mouth or through an inhaler.

• Watch your symptoms and know what to do if they get worse. Experts advise making an Asthma Action Plan with your healthcare provider.

Your healthcare provider may also refer you to a specialist, such as an allergist or pulmonologist (lung expert).

Living with asthma

You can better manage your asthma symptoms by taking care of yourself. Be sure to:

• Get about 8 hours of sleep each night.

• Exercise or be active for about 30 minutes on most days. Talk with your healthcare provider about how to exercise safely if exercise triggers your asthma symptoms.

• Stay engaged with family and friends.

• Keep up-to-date on your vaccines.

• Eat healthy. Fill up on lots of fruits and vegetables and whole grains. Choose lean meats, fish, and low-fat dairy.

When should I call my healthcare provider?

Call your healthcare provider or get medical attention right away if you are having an asthma attack and your symptoms are not getting better after using your asthma medicine. You may be having a severe asthma attack.

Key points about asthma in older adults

• Asthma is a long-term disease of the airways of the lungs. You can get it as an older adult even if you’ve never had it before.

• Asthma in older adults may be harder to diagnose. It can be hard to tell asthma from health problems, such as heart failure and COPD.

• Asthma symptoms include coughing, wheezing, and shortness of breath.

• A spirometer can help diagnose asthma.

• There is no known cure for asthma. You can control it by staying away from your asthma triggers and by taking your asthma medicine as prescribed.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.