Asthma Strikes Adults, Too

Asthma is commonly thought of as a disease of children, but it affects adults as well, and can be a serious condition, particularly for older adults.

Asthma that begins in adult life may be more persistent and more resistant to typical medications. More than 4.8 million Americans over the age of 35 suffer from asthma. While some children outgrow asthma as they age, asthma may disappear only to reappear many years later.

The first key to effective treatment is for patients to work with their doctor to identify environmental factors that cause their asthma. After identifying these triggers, it may be possible to predict when an asthma incident will occur and proactively treat it. These environmental factors range from cigarette smoke to pollen to cold air. Exercise may also trigger an attack but should not be avoided. Proper premedication will allow beneficial exercise to be performed. Studies confirm that regular exercise improves the quality of life in patients with asthma.

During an asthma attack, the lining of the airway swells and breathing becomes difficult or impossible. The asthma sufferer may be unable to breathe deeply and can only gasp for air, which is not only frightening but can be a life-threatening situation.

Asthma, however, is generally controllable with medications. Asthma is a chronic inflammation of the bronchial lining which requires medication to reduce the misdirected activity (inflammation in this case) of the immune system. An inhaler is a common form of treatment to control asthma attacks. Inhalers are small pumps used to release medication into the airway, relieving inflammation in the lungs, thus controlling the symptoms of an attack.

Special concerns arise for older adults with asthma who may not be able to use traditional treatments like an inhaler. For example, sometimes arthritis or another debilitating condition may hinder proper usage of an inhaler. In these cases, different treatment options should be investigated. One solution may simply be an inhaler equipped with a special handle that does not require downward force to administer medication.

Another option is to use a device called a nebulizer which creates a fine mist of medication and delivers it more effectively to the airway. For older patients, a nebulizer may be a less stressful form of treatment.

With aging, a person's metabolism, their sensitivity to medication, and sleep patterns change, and this can influence the effectiveness of medications. As a result, older patients should see their doctor regularly to be sure they are receiving the proper dosage of medication.

Drug interaction is an additional concern for older asthma patients. If the wrong drugs are used together, they may not have the intended effect. In order to avoid dangerous drug interactions, patients must inform their doctor of all other medications they are taking.

Asthma is generally a manageable disease at any age. Visiting the doctor regularly and developing a treatment plan are the keys to managing asthma effectively, often with only minimal lifestyle changes.

Kevin J. Kelly, MD
Professor of Pediatrics and Medicine
Medical College of Wisconsin

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.