Asthma is both a new and old foe for seniors. Some over 65 are wheezing for the first time. They are a member of a growing group of seniors with new-onset asthma. Others are among the rising population of long-time asthma sufferers. For this group, the asthma diagnosis is a distant memory, but now additional health challenges make managing asthma more complex.
One third to one half of all people with asthma have had it since childhood. In many cases, asthma just doesn't go away. It's important to get your asthma under control at any age, but especially so for older adults. Seniors with asthma are five times more likely to die of an asthma attack compared to younger people.
Problems Unique to Elderly
Asthma in seniors can be more challenging to diagnose and manage for a number of reasons:
- Asthma symptoms can be confused with other lung and heart problems common in seniors, such as chronic bronchitis, emphysema or heart failure.
- Seniors may not have classic asthma symptoms even though their airways are constricted. They may simply feel "tired" and don't realize that the fatigue is asthma-related.
- In seniors, airway constriction may not be fully reversible. So shortness of breath, wheezing and other asthma symptoms may not go away completely after taking medications. This may be due to buildup of mucus in the lungs, which may also lead to a chronic cough.
- Seniors often take multiple medications. This could lead to side effects and drug interactions and can alter the effectiveness of asthma medications.
- Using the metered-dose inhaler correctly may be a challenge for seniors, possibly due to arthritis or loss of hand strength.
How do I know if I have asthma?
It may be hard to recognize the symptoms of asthma. Common symptoms are:
- Wheezing. A wheezing sound when you breathe. This may happen only when you have a cold. Not everyone with asthma wheezes.
- Cough. You may or may not cough up mucus. The cough can come and go and may last a week or more.
- Shortness of breath. This is the feeling that you cannot get enough air into your lungs. You may have only occasional trouble breathing or have it frequently.
- Chest tightness. This could be a sign that your asthma is getting worse. Your chest could feel tight when it is cold out or during exercise.
But any of these symptoms, especially chest tightness and shortness of breath, can also be a sign of angina or heart disease. See your doctor right away if you have been having any of these symptoms so that you can get the correct diagnosis and treatment.
Is my asthma treated differently than for younger people?
Seniors with asthma, like younger asthma sufferers, are usually treated with two medications: a controller medicine and a quick-relief medicine.
The controller medicine is taken every day as maintenance therapy even if you are feeling fine. It helps prevent asthma symptoms from starting. The quick-relief medicine is used to stop an asthma attack when you have symptoms.
Your doctor will choose asthma medicines that are least likely to make any other medical conditions worse. Your doctor will also consider all the other medicines that you take to avoid interactions with asthma meds. Your doctor will consider that:
- Some heart and blood pressure medicine can cause constriction of the breathing tubes and make asthma worse.
- Some bronchodilators can raise blood pressure and heart rate, or cause an irregular heart rhythm.
- Some drugs that make you sleepy can interfere with breathing and make asthma worse.
Help your doctor manage your asthma by:
- Telling your doctor about all the medications you are taking, including over-the-counter pills
- Reminding your doctor and pharmacist about all your medicine every time you get a new prescription
- Informing all of your doctors that you have asthma
Other tips for seniors with asthma
Bring a list of questions and all of your medications to each doctor's visit. Tell your doctor if you have recently been to the emergency room for your asthma. Ask if you need to see an asthma specialist, such as an allergist, immunologist or pulmonologist.
- Review your inhaler technique with your doctor. Have your doctor watch you use your inhaler to make sure you're doing it right. If you have trouble, tell your doctor to demonstrate for you.
- Review your asthma action plan with your doctor. This is a list of instructions for you to follow on your own, based on your asthma symptoms and peak flow.
- Discuss your bone health with your doctor. Taking inhaled corticosteroids, especially in high doses for a long time, can increase your risk for bone breaks. Talk to your doctor about bone density tests and taking calcium and vitamin D supplements.
- Get a flu shot and a pneumonia vaccine. These respiratory infections are a trigger for asthma.
- Get a medical alert bracelet stating that you have asthma.
Created on 06/24/1999
Updated on 10/19/2009
- National Heart Lung and Blood Institute. National Asthma Education and Prevention Program Working Group REPORT: Considerations for diagnosing and managing asthma in the elderly.
- American Academy of Allergy, Asthma and Immunology. Seniors and asthma.
- Stupka E, deShazo R. Asthma in US seniors: part 2. Treatment. Seeing through the glass darkly. American Journal of Medicine. 2009;122(2):109-113.
- Stupka E, deShazo R. Asthma in seniors: part 1. Evidence for underdiagnosis, undertreatment, and increasing morbidity and mortality. American Journal of Medicine. 2009;122(1):6-11.
- American Lung Association. Asthma and older people.