Asthma in Individuals Over 60 Years: A Comparative Analysis Across Age Subgroups

Martyna Miodońska,1 Andrzej Bożek,1 Ewa Urbaniec,2 Dominika Sadowska,1 Aleksandra Mitka,1 Aleksandra Foks-Ciekalska,1 Szymon Mućka,1 Anna Kwaśniak,1 Jolanta Zalejska-Fiolka,3 Marita Nittner-Marszalska4 1Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia in Katowice, Zabrze, Poland; 2Medical Center of Allergology and Laryngology, Łaziska Górne, Poland; 3Department of Biochemistry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland; 4Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, Wroclaw, PolandCorrespondence: Martyna Miodońska, Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia in Katowice, ul. Marii Skłodowskiej-Curie 10, Zabrze, 41-800, Poland, Email martynamiodonska298@gmail.comPurpose: Asthma is often not adequately treated in individuals over 60 years of age due to atypical symptom presentation, comorbidities that overlap with asthma symptoms, and difficulties with diagnostic testing. The aim of this study was to evaluate asthma control, its phenotypes, accompanying comorbidities and quality of life, as well as treatment patterns, in patients aged 60 years and older. The assessment also covered asthma treatment and control in specific age subgroups.Patients and Methods: A multicenter, cross sectional study of 345 asthma patients over 60 years of age and 410 matched controls without obstructive lung disease was conducted. Spirometry, Forced Oscillation Technique (FOT) assessment, bronchodilator reversibility test, and patient-reported outcome data, including Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), and 36-Item Short Form Survey (SF-36) data were analyzed.Results: Severe asthma was present in 25% (n=87) of the study population. A total of 48% (n= 165) of all asthma patients presented the T2 phenotype. The FOT proved useful where spirometry was limited. The asthma patients had significantly higher rates of depression (p=0.02), cognitive decline (p=0.02), and multimorbidity (p=0.01) than the non-asthma patients did. The quality-of-life score (AQLQ) was consistently lower in the asthma group: 3.78 ± 0.91 (median ± interquartile range) vs 4.29 ± 1.81 in non-asthma group (p=0.01). In the analysis of subgroups, older patients over 80 years had significantly poorer asthma control, and reduced quality of life in SF-36 questionnaire (55.521 score in younger vs 46.991 in older, for p=0.01).Conclusion: Asthma in older age is often associated with other comorbidities, which can have a significant impact on a person’s quality of life and general health. Patients are often undertreated, which results in poorer asthma control, particularly among the oldest patients.Keywords: elderly, late-onset asthma, spirometry, FOT, asthma phenotypes, quality of life