09:57am Saturday 04 April 2020

Shortness of Breath: Old Age or Asthma?

Mistaken for illnesses like bronchitis and emphysema, exacerbated by medications like aspirin, and overlooked by patients and doctors alike, asthma is a common and highly treatable condition in older adults. And while allergies tend to decrease with age, they also are frequently disregarded as a potential cause of misery for the elderly.

Raymond Slavin, M.D.  

In spite of the common belief that asthma is a young person’s disease, at least 40 percent are 40 or older at the time of their first asthma attack. Raymond Slavin, M.D., SLUCare allergist and professor of internal medicine at Saint Louis University School of Medicine, says there is evidence that it’s underdiagnosed.

Too often, seniors don’t receive treatment for asthma – a recent study showed 39 percent received no treatment at all – compromising quality of life and risking hospitalization. In addition, older adults who suffer from asthma are the only age group in which asthma is getting worse, with 60 percent of asthma deaths occurring in those 65 or older.

“Don’t simply chalk up shortness of breath to aging,” said Slavin. “Asthma in the elderly is not rare. In fact, it’s rather common.

“The good news is that once we identify asthma, it has an extremely effective treatment.”

One reason aging brings an increased risk of asthma is that our lungs, blood vessels and connective tissue change structurally as we age, causing a drop in our lung function.

And, because of the misconception that adult-onset asthma is rare, it may be confused with bronchitis, emphysema or sinusitis.

Medications also play a role. Beta blockers and ACE inhibitors, used to treat common illnesses in seniors, like heart attacks, hypertension and congestive heart failure, can cause shortness of breath, wheezing and coughing. Aspirin, which frequently is taken for arthritis, can cause asthma.

Allergies, too, are frequently missed in the elderly, says Slavin in a recent article published in Allergy and Asthma Proceedings. Although they tend to decrease with age, when seniors do suffer from allergies, they are often mistaken for another condition.

Slavin says that cats, dogs, and even cockroaches can be culprits, and warns that effective treatment is necessary not only to minimize the impact of allergies in seniors, but to prevent the exacerbation of asthma, as well. Allergies and asthma are often connected, with 90 percent of asthmatics suffering from allergy symptoms, such as a stuffy nose.

Bottom line? Consider the possibility that asthma and allergies may be causing symptoms, says Slavin. Treatments can dramatically improve quality of living, as well as save lives.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.

Carrie Bebermeyer

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