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Vital Signs

Senior Citizens At Risk for Untreated Asthma

Many elderly people have moderate or severe asthma that has been underdiagnosed or undertreated, according to a recent study by Johns Hopkins University. The elderly also experience a decreased quality of life as a result of asthma, according to Karen Huss, RN, DNSc, a nurse researcher and associate professor at the John Hopkins University School of Nursing.

In Huss’s study of 80 senior citizens over age 65, published in a recent issue of Annals of Allergy, Asthma and Immunology, she found that two thirds of the participants had either moderate or severe persistent asthma caused primarily by elements in the home such as dust mites, mold and allergens from cockroaches, cats and dogs. Asthma medication was either not being used or being used improperly. These findings are particularly important for minority elderly, who are at a greater risk for asthma than Caucasians.

“Asthma is a significant, chronic problem in the elderly,” says Huss. “Despite the high prevalence, major allergens in the homes have not been identified. We conducted home visits to collect dust samples and evidence of other allergens. That is the first step in alleviating the problem.”

 

Nearly 75% of elderly in the study tested positive to airborne allergens, and 53% were skin-test positive to at least one indoor allergen. Senior citizens were primarily sensitive to indoor allergens, and allergen levels in their homes were often high enough to place the elderly at risk for asthma complications.

 

“Our data also suggests that asthma in the elderly contributes to a decreased quality of life,” Huss notes. Those with more severe asthma reported more negative feelings about life in general, described their health as being poor and had a greater degree of impairment during daily activities. This finding implies that senior citizens with severe asthma are less likely to engage in domestic activities such as dusting and vacuuming, leading to higher allergen levels and ultimately exasperating severe asthma.

Few elderly persons take proper medication to treat their asthma, according to the researchers. One third of the elderly participants in the study were not taking inhaled steroids, the preferred method of treating asthma.

“It is critical that we first identify and control allergens in an elderly person’s environment in order to avoid asthma attacks,” says Huss. “Skin tests need to be done on elderly patients with asthma so they will know what to avoid. Once allergens in the home are reduced and medications that combat inflammation in the airways are introduced, then asthma severity in the elderly should decrease and the quality of life should improve.”