Can Asthma Start Later In Life

August 21, 2021

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What Is An Asthma Action Plan

Your healthcare provider will work with you to develop an asthma action plan. This plan tells you how and when to use your medicines. It also tells you what to do if your asthma gets worse and when to seek emergency care. Understand the plan and ask your healthcare provider about anything you dont understand.

Asthma Symptoms Can Mimic Other Illnesses Or Diseases Especially In Older Adults For Example:

Hiatal hernia, stomach problems, heart failure, or rheumatic arthritis can create asthma-like symptoms.
Chronic obstructive pulmonary disease has many of the same symptoms as asthma. COPD, which includes emphysema and chronic bronchitis, is very common in older adults especially those who are or have been smokers.

What Is The Treatment For Asthma

Asthma symptoms can be treated with a variety of prescription medications that provide quick relief as well as long term control. Lifestyle changes can also reduce symptoms, especially if asthma is triggered by allergies to substances in the environment or to certain foods . Regular vaccinations for influenza and pneumonia are strongly recommended for older adults with asthma.

Keep in mind . . . Short-term use of oral steroids are helpful to treat acute asthma symptoms, or flare ups; however, long-term use of oral steroids is usually avoided in older asthma patients. Over time, oral steroids can cause severe side effects, such as weakening of bones, ulcers, or high blood pressure.

People with asthma should develop a written asthma management plan with their physician. An asthma management plan outlines specific treatment and lifestyle practices, including what to do when asthma symptoms flare up or become out of control.

Older asthma patients should be sure to ask their physician about any aspect of their asthma treatment that they do not understand. Keeping the physician informed about how well treatment is working is important. Patients need to tell their physician if they are having trouble remembering to take their medications, or if they are having difficulty using devices such as an inhaler.

Symptoms Like Coughing Wheezing And Feeling Breathless Could Mean You Have Asthma See Your Gp To Confirm A Diagnosis Of Asthma And Start Treatment

Find out why its important to get a diagnosis so you can start treatment for asthma, how asthma is diagnosed, and how you can take positive steps to stay symptom free after a diagnosis.

tightness in the chest
feeling short of breath.

Not everyone with asthma will get all of these. For example, not everyone wheezes. But if youre experiencing one or more of these symptoms, make an appointment with your GP.

Most people with well-managed asthma only have symptoms now and then. But some people have symptoms a lot of the time, particularly the small percentage of people with severe asthma.

A key thing with asthma is that symptoms come and go – you may not have them all the time.

Why its important to see your GP to confirm a diagnosis

If youve noticed asthma-like symptoms, dont ignore them. Make an appointment with your GP or an asthma nurse as soon as you can.

The quicker you get diagnosed, the quicker you can get the right medicines to help you deal with your symptoms.

Asthma is a long-term condition that needs regular preventer treatment. If its not treated, it could lead to an asthma attack which can be life-threatening.

Distinctive Features Of Copd Management

Stable COPD requires both nonpharmacological and pharmacological management. illustrates a stepwise approach to guide treatment decisions.

Stepwise management of Stable COPD.

Abbreviations: COPD, chronic obstructive pulmonary disease; COPD-X, Confirm diagnosis, Optimise function, Prevent deterioration, Develop support, manage eXacerbations; FEV1, forced expiratory volume in 1 second; GP, general practitioner; ICS, inhaled corticosteroids; LABA, long-acting beta-agonist.

Altered Perception Of Airway Obstruction

Some data have suggested that for people over 65 years, those with adult-onset asthma of a longer duration may have more severe airway obstruction than those with a more recent asthma diagnosis, yet they report fewer asthma symptoms. This might adversely influence the implementation of an asthma action plan, which relies on the accurate interpretation of asthma symptoms. Older individuals might attribute respiratory symptoms to bronchitis, respiratory tract infection, obesity, poor fitness, or even to the aging process and be more accepting of a progressive decline in mobility and activity.

Managing Your Asthma Well In Later Life

Continue to have regular asthma reviews

Whether youve had asthma all your life or youve been diagnosed with it as an older adult, an asthma review helps you stay on top of any changes in your symptoms.

You can make sure your asthma action plan is up to date, review your asthma medicines, and check youre taking the lowest dose possible to stay well and avoid side effects.

Track your symptoms

Keeping track of your symptoms makes it easier to spot any changes. Write down your symptoms in a diary, notebook, or on your phone and take it along to your next appointment.

Remember to make a note of anything you were doing that day or any triggers you came across – you may notice youre sensitive to new things that were not a problem before.

Dont ignore symptoms like breathlessness, says Dr Andy. Its easy to think that feeling a bit more breathless is just another sign that youre not as fit as you used to be.

But if youre feeling out of breath climbing stairs or walking uphill, see your GP to get it checked out. Breathlessness can be a sign that your asthma is not well controlled. It could also be a sign of another health condition.

Act quickly if symptoms get worse

To cut your risk of an asthma attack, take action as soon as you notice symptoms getting worse. As we get older, asthma attacks can be more severe and take longer to recover from.

Check your inhaler technique

Ask about side effects

Get help for other conditions too

Find out more about other conditions.

Asthma In The Elderly: Can We Distinguish It From Copd

Eleni G. Tzortzaki

1Department of Thoracic Medicine, University Hospital of Heraklion and Medical School, University of Crete, Heraklion 71110, Crete, Greece

Abstract

Asthma in older adults affects quality of life and results in a higher hospitalization rate and mortality. In common clinical practice, asthma in the elderly is underdiagnosed and undertreated or overdiagnosed and mistreated. The age-related reduction in perception of shortness of breath and the high incidence of comorbidities make the diagnosis and management more difficult and challenging for the physicians. Chronic obstructive pulmonary disease is usually easy to distinguish from asthma, but sometimes the distinction from late-onset asthma in older patients, particularly in cigarette smokers, is difficult and may be impossible. Both diseases are characterized by the presence of airflow obstruction but have distinct pathogenesis, inflammatory pattern, and prognosis. The distinction between Asthma and COPD based simply on spirometric parameters is difficult especially in the elderly asthmatics. The combination of lung function testing, bronchial hyperresponsiveness and atopy status, HRCT scans, and the newly developed biological techniques, allowing the assessment of biomarker profiles, could facilitate the distinction between these diseases.

1. Introduction

COPD

The aim of this paper is to highlight the main and more useful tools for Asthma and COPD differentiation in the elderly.

4. Structural Changes

Action Plans And Self

Action plans for exacerbations are effective in asthma, allowing patients to develop coping skills, anticipate early exacerbation symptoms, self-initiate appropriate treatment, and seek medical advice prior to significant deterioration. Trials assessing the effects of action plans in COPD management have shown conflicting results, with variable adjuncts to patient care likely contributors. Those with positive results, such as expedited exacerbation recovery and reduced hospital admissions, have included additional supports, such as intensive education and case management. In contrast, action plans with limited or no SME and no case management have little beneficial effect.

A recent randomized controlled trial that suggested an unexpected increase in all-cause and COPD-specific mortality with a comprehensive care management program including a COPD action plan for US veterans, highlighted the value of identifying those with adult-onset asthma for whom the benefits are well-documented. Putting this disturbing finding into the context of the COPD literature is important, and identifying factors predisposing to a poor outcome will be a challenge for those involved in developing clinical practice guidelines. While the association did not appear related to increasing age or COPD severity, these findings suggest that self-management programs may not be appropriate for all patients with COPD.

What Is Asthma And What Causes It

Asthma can start during early childhood or develop later in life; the cause is most often unknown or identified as an allergic response of the upper airways to any environmental triggers. An asthma attack cannot only be induced by allergens, but also by sudden changes of air humidity or temperature, as well as inhalation of fumes generated by evaporation of chemicals, or from cooking or heating. Besides inhaled triggers, asthma attacks can be resulted from psychological stress, sports or food allergens. The question which mechanism links all these diverse triggers to develop asthma remains open.

Spacers For Asthma Medication

It is recommended that all people with asthma, regardless of age, use a spacer when taking medication via a metered-dose inhaler .

Spacers help to improve the delivery of asthma medication to the lungs and minimise side effects from medications. Talk to your doctor or pharmacist about spacers and how they might help you manage your asthma.

which demonstrate how to use a puffer and spacer.

Other Ways To Stay Well In Later Life

Stay active

Studies have shown that people who keep have more chance of staying healthy as they get older.

Even if your mobility isnt as good as it was or you find you get tired easily, there will be an activity you can do.

Keep to a healthy weight

Keeping to a healthy weight can lower your risk of asthma symptoms. Studies show that if youre very overweight, even losing a bit of weight, can make a difference to your asthma.

It can feel harder to shift the weight as you get older, particularly if youre less active than you were. Find out what support you can get.

Stop smoking

If you smoke, youre more at risk from asthma symptoms and attacks, as well as COPD.

Giving up smoking not only lowers your risk, but it also means your medicines will be more effective.

Theres lots of free support to help you quit.

Look after your mental health

If youre worried, down, or lonely, talk to someone about how you feel. Age UK has an Advice Line: 0800 169 2081.

Stress, anxiety and can all trigger asthma symptoms.

We all need a support network of friends, family and neighbours, says Dr Andy. Share your asthma action plan, so that anyone caring for you knows what to do if symptoms get worse and who to call for help. And tell your GP or asthma nurse how youre feeling too.

You can talk to a respiratory nurse specialist on our Helpline: 0300 222 5800 . Or you can WhatsApp them on 07378 606 728

Next review due December 2023

Can You Outgrow Asthma

If you or your child have asthma, youll be relieved to know that it is possible to outgrow the symptoms.

Of the approximately 7 million U.S. children with asthma, about half of them will outgrow it once they reach adolescence. Even if an individual outgrows asthma, its important to remember that the respiratory tract will remain sensitive to asthma triggers for life.

In fact, theres a chance that people whose symptoms disappear will see them reappear in varying degrees when they enter their late thirties or early forties. Researchers dont fully understand why some individuals see a resurgence of symptoms, but they have noted that both old and new triggers can cause them in people with a history of asthma.

How Do You Get Asthma

Doctors know, however, that asthma can sometimes run in families.
Asthma attacks can be set off by many different things, these are called triggers. Examples include cold air, vigorous exercise and .
These triggers may also include ‘allergens’. These are present in the environment and contain chemicals that trigger allergic reactions.
Allergens include, for example, pollen, animal danders, house dust, pollution, some foods, perfumes and cigarette smoke.
Allergens cause the lining of the airways to become swollen and inflamed. It produces extra mucus and the muscles of the airways tighten. There is then less room for the air to pass in and out.
Attacks may be more frequent or severe in people who have a chest infection.

How Can Adult Onset Asthma Be Managed

If you manage your asthma, you can expect to lead a normal lifestyle. Basically, there are four key steps to managing asthma successfully:

1. Learn about asthma and stay up-to-date on new developments.

2. Take prescribed medications. Dont make any changes until you check with your physician. Dont use over- the-counter medications unless prescribed by your physician!

3. Check your lungs daily at home by using a peak flow meter. Asthma patients often can detect lung changes with a peak flow meter before they actually experience any changes. Visit your physician regularly for further in-office tests. Lung testing is painless and provides valuable data that helps your physician make adjustments in your medication.

4. Make an asthma management plan with your physician. A plan establishes guidelines that tell you what to do if your asthma symptoms get worse.

Are There Any Special Considerations For Adults With Asthma

Many adults take several medications and/or use over-the counter medications, such as ibuprofen or aspirin, regularly. Work with your doctor to simplify your medication program as much as possible. Explore the possibility of combining medications or using alternate ones that will have the same desired effect. Be sure to discuss potential drug interactions with anything you take, including vitamins. Some asthma medications increase heart rate. If you have a heart condition, discuss those side affects with your health care provider. Older “first generation” antihistamines can cause men with enlarged prostates to retain urine. Oral steroids can make symptoms of glaucoma, cataracts and osteoporosis worse. Adults with arthritis may need special inhalers that are easier to operate. Anyone with asthma should consider getting an annual flu shot. Older adults also should talk with their doctor about getting a pneumonia vaccination. People with multiple medical conditions need to be aware of how their illnesses may affect one another.

What Asthma Treatment Options Are There

You have options to help manage your asthma. Your healthcare provider may prescribe medications to control symptoms. These include:

Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways. They make it easier for air to enter and exit your lungs. Your healthcare provider may prescribe them to take every day to control or prevent your symptoms.
Bronchodilators: These medicines relax the muscles around your airways. The relaxed muscles let the airways move air. They also let mucus move more easily through the airways. These medicines relieve your symptoms when they happen.
Biologic therapies for asthma when symptoms persist despite being on proper inhaler therapy.

You can take asthma medicines in several different ways. You may breathe in the medicines using a metered-dose inhaler, nebulizer or other inhaler. Your healthcare provider may prescribe oral medications that you swallow.

Q: What Increases Your Risk For Adult

A: Most childhood asthma disappears in adulthood. But having childhood asthma increases your risk of a relapse in your 30s or 40s. Other factors that increase the risk of adult-onset asthma include:

Being overweight or obese: A low level of physical activity, changes in lung physiology and higher levels of inflammation are among several factors at play.
Being : Hormonal fluctuations in pregnancy and menopause can trigger asthma.
Allergens: Cats, cigarette smoke, chemicals, mold or dust can trigger asthma.

Surprising Signs Of Adult

How Do I Know If My Child Really Does Have Asthma

A doctor’s work-up will start with a medical history including symptoms and family history. A physical exam will also be done. Pulmonary function testing with spirometry can provide information about lung function and severity of the asthma. A chest X-ray may be ordered to help visualize the lungs. Allergy testing can be done to determine if allergies play a role in symptoms. Additional tests may be done to investigate other causes of symptoms.

The Need For Understanding

Despite of thousands of studies, the major problem to progress with diagnosis and therapy of asthma seems to be the lack of understanding how different cell types and pro-inflammatory, as well as inflammatory mechanisms affect each other. It would be a big step forward if future studies would be able to monitor a small cohort of patients from the first diagnosis of asthma over several years with unchanged methods of analysis. These studies should obtain samples like blood, sputum, or bronchial fluids on a regular basis of short intervals , and compare the clinical parameters with metabolomic, proteomic, and transcriptomic analyse. The aim of such studies should be to determine if biomarkers and therapeutic targets for asthma vary with time, and condition, or if they are stable indicators for the disease. Only when we know if the biomarkers are stable or specific for a condition such as exacerbation or allergic response we will be able to use them as diagnostic tools.

How Is Adult Onset Asthma Diagnosed

Asthma symptoms can mimic other illnesses or diseasesespecially in older adults. Hiatal hernia, stomach problems or rheumatoid arthritis can create asthma-like symptoms. Chronic obstructive pulmonary disease has many of the same symptoms as asthma. COPD, which includes emphysema and chronic bronchitis, is very common in older adults, especially those who are or have been smokers. To diagnose asthma, your physician will question you about your symptoms, do a physical exam, and conduct lung function tests. In addition, you may be tested for allergies. Your primary care physician may refer you to a pulmonologist or an allergist for specialized testing or treatment. If you have any asthma symptoms, don’t ignore them or try to treat them yourself! Get a definitive diagnosis from your health care provider.

If Your Asthma Symptoms Are Caused By Allergies Take Steps To Control Knownor Potential Triggers In Your Environment

Allergy-proof your house for dust, mold, cockroaches, and other common indoor allergens to which you are allergic.

Reduce your outdoor activities when the pollen count or ozone level is high.

Choose foods that dont contribute to your asthma or allergy symptoms.

Evaluate your workplace for possible allergens and take the necessary steps to reduce your exposure to them.

In order to determine relevant triggers, you may want to seek consultation with an allergist who can further define these triggers.

In addition, anyone with asthma should consider getting an annual flu shot. Older adults also should talk with their internist about getting a pneumonia vaccination.

Risk Factors For Adult

Both asthma and COPD are acknowledged as complex diseases related to both genetic and environmental risk factors, but environment seems to play the stronger role. Although asthma has a high heritability, genetic studies to date have been able to explain only a small proportion of the variability. The evidence for a genetic etiology of adult-onset asthma is even less convincing, with neither family history nor atopy being clearly linked to this phenotype. Homozygous -1-antitrypsin deficiency is the most common genetic risk factor for COPD, and the odds are also increased among heterozygous alpha-1-antitrypsin deficient smokers. Very recently, an interaction has been demonstrated between the PiMZ genotype and occupational exposures to vapors, gas, dust, and fumes, on annual decline in lung function.

A growing body of evidence suggests that early life and childhood factors are important in both adult-onset asthma and COPD., This concept is based on data that show associations between various adverse perinatal outcomes and harmful environmental stimuli, with slowing of lung function growth for susceptible children and adolescents. This effectively reduces peak lung function and impacts on the corresponding trajectory of lung function decline in adulthood. Such prenatal and postnatal factors include intrauterine growth restriction, prematurity, second-hand smoke exposure, air pollution, recurrent respiratory infections, and personal smoking.

Asthma Related To Sensitising Or Irritant Exposure In The Workplace

Occupational asthma has become the most common type of adult-onset asthma in many industrialised countries, having been implicated in 915% of adult-onset asthma . Two types of occupational asthma have been defined: sensitiser induced and irritant induced .

Sensitiser-induced asthma is a subtype of occupational asthma typically presenting with a latent period of exposure, followed by the onset of clinical disease. After sensitisation, airway reactions develop from levels of exposure to the sensitising agents that were tolerated before sensitisation. Although the mechanism causing occupational asthma from some sensitisers has been demonstrated to have an immunological basis , the mechanisms for some suspected sensitisers are yet to be defined. There are more than 250 agents that have been adequately documented to cause sensitiser-induced asthma . Some sensitising agents have differential effects on asthma onset depending on the dose. For example, in farmers, exposure to low-dose endotoxins and fungal spores appears to have a protective effect on the development of atopic asthma but may induce non-atopic adult-onset asthma at higher doses .

Preparing For Your Gp Appointment

A little bit of preparation can help you to get the most of your first GP appointment. It may even speed up the process so you can get diagnosed more quickly.

Have answers at the ready

Think about your family history.

Does anyone in your family have asthma?
Does anyone in your family have allergies?
Do you have any allergies, including eczema or hay fever?

Your answers to these questions could help your GP work out if asthma is more likely.

Keep a diary of your symptoms

Note down how often and when you have symptoms. For example, are your symptoms worse at night, early in the morning, or when youre at work?

You could also make a note of what you think sets them off. Things that set off your asthma symptoms are called . Common asthma triggers include dust mites, cigarette smoke, and .

Keeping a diary or a chart of your symptoms and triggers can help your GP or asthma nurse see the pattern of your symptoms. Seeing how your symptoms are over time helps your GP to know if asthma is more likely.

Film symptoms on your phone

Asthma can come and go, so you could have no symptoms when you go and see your GP.

Try filming yourself on your phone – or ask someone else to when youre having symptoms. Then you can show the GP or asthma nurse exactly what it was like, without having to try and describe it with words.

But dont delay getting help if symptoms are getting worse though!

Jot down your questions

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