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BACKGROUND
Asthma is prevalent among elderly Australians but is often misdiagnosed and undertreated. Asthma presents with the same clinical features in the elderly as in the younger population.
OBJECTIVE
This article identifies current knowledge about the needs of elderly people with asthma, as well as the knowledge gaps currently existing in this area of health care.
DISCUSSION
A significant proportion of elderly people with asthma go undiagnosed. Elderly patients under-report symptoms and attribute breathlessness to age and other comorbidities. Other difficulties include impaired perception of asthma severity, poor medication adherence, physical disability, cognitive dysfunction, and a passive self management approach. These all contribute to poorer asthma outcomes among the elderly. The management of asthma among the elderly is likely to improve if specific needs are addressed with tailored educational interventions and appropriate care.
Asthma is an inflammatory airway disease; airway hyper-responsiveness causes narrowing in response to a wide range of environmental stimuli such as allergens or exercise.1 This leads to symptoms such as coughing, wheezing, breathlessness and chest tightness.1 Asthma symptoms are usually associated with pulmonary airflow obstruction, which is often reversible with treatment.1
An older patient is defined as a person aged 65 years and over. Only a small number of studies have looked at the specific needs of elderly patients with asthma.
Research indicates that despite the fact that the majority of patients indicate their asthma is well controlled and are satisfied with the asthma care provided to them,2,3 many report ongoing asthma symptoms and exacerbations.2 Clinicians often fail to address the different areas of asthma management when providing asthma education.2
A few studies have suggested that poor management of asthma is common in older patients and that this has a negative impact on quality of life (QOL).4-9 It is important therefore to gain a better understanding about the specific needs of elderly patients and to develop educational interventions which can improve overall health status and QOL in this population group.
Prevalence
The prevalence of asthma among Australians aged 65 years and over ranges from 7-15%, a rate similar to the rest of the adult population.10,11 However, misdiagnosis and underdiagnosis are common in the elderly and it remains difficult to estimate the true prevalence in this group.5,9,11-14
Diagnosis
Difficulties can occur when...