Background: In the geriatric population, asthma tends to be overlooked. Moreover, typical symptoms of asthma may mimic chronic bronchitis and emphysema. Objective: To compare the characteristics of asthma between elderly (≥65 years) and adult (<65 years) asthma patients with regard to asthma severity, health-related quality of life, and direct expenditures for medical care generated by the disease. Methods: A cross-sectional study was made in the asthmatic population older than 14 years in the area of Barcelona, Spain. Asthma severity was determined according to the International Consensus criteria of 1992. St. George’s Respiratory Questionnaire (SGRQ) was used to measure the quality of life. Direct costs were calculated registering all costs generated by each patient per year. Results: The study population consisted of 282 adult asthmatics and 51 elderly asthmatics. Asthma was more severe in the elderly group (mild 10%, moderate 35%, severe 55%) than in the adult group (mild 47%, moderate 35%, severe 18%). Elderly asthmatics had significantly higher total SGRQ scores (48 vs. 35, p < 0.001) than adult asthmatics, as well as significantly higher scores for all subscales. Asthma-derived direct costs in elderly asthmatics (mean USD 1,490 vs. USD 773) were double those in adult asthmatics, mainly due to higher costs of hospitalization and medication in the elderly. Conclusions: Asthma in elderly people as compared with asthma in adulthood was more severe and was associated with a worse health-related quality of life, and significantly higher expenditures for medical care.

1.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention NHLBI/WHO Workshop Report. National Institutes of Health. National Heart, Lung, and Blood Institute. 1995;95:3659.
2.
Evans R, Mullally DI, Wilson RW, Geigen PJ, Rosenberg HM, Grauman JS, Chevarley FM, Feinleib M: National trends in the morbidity and mortality of asthma in the US. Chest 1987;91:65S.
3.
Aberg N: Asthma and allergic rhinitis in Swedish conscripts. Clin Exp Allergy 1989;19:59–63.
4.
Burney PGJ, Chinn S, Rona RJ: Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973–86. BMJ 1990;300:1306–1310.
5.
Weiss KB, Gergen PJ, Hodgson TA: An economic evaluation of asthma in the United States. N Engl J Med 1992;326:862–866.
6.
Bousquet J: A physician’s view on health economics in asthma. Eur Respir Rev 1995;5:275–278.
7.
Braman SS: Asthma in the elderly patient; in Fein AM (ed): Pulmonary Disease in the Elderly Patient. Clin Chest Med 1993;14:413–422.
8.
Broder I, Higgins MW, Mathews KP, Keller JB: Epidemiology of asthma and allergic rhinitis in a total community, Tecumseh, Michigan. IV. Natural history. J Allergy Clin Immunol 1974;54:100.
9.
Broder I, Higgins MW, Mathews KP, Keller JB: Epidemiology of asthma and allergic rhinitis in a total community, Tecumseh, Michigan. III. Second survey of the community. J Allergy Clin Immunol 1974;53:127.
10.
Burrows B, Barbee RA, Cline MG, Knudson RJ, Lebowitz MD: Characteristics of asthma among elderly adults in a sample of the general population. Chest 1991;100:935–942.
11.
Braman SS, Kaemmerlen JT, Davis SM: Asthma in the elderly. A comparison between patients with recently acquired and long-standing disease. Am Rev Respir Dis 1991;143:336–340.
12.
Burrows B, Lebowitz MD, Barbee RA, Cline MG: Findings before diagnoses of asthma among the elderly in a longitudinal study of a general population sample. J Allergy Clin Immunol 1991;88:870–877.
13.
Nejjari C, Tessier JF, Barberger-Gateau P, Jacqim H, Dartigues JF, Salamon R: Functional status of elderly people treated for asthma-related symptoms: A population-based cases-control study. Eur Respir J 1994;7:1077–1083.
14.
International Consensus Report on Diagnosis and Treatment of Asthma. Clin Exp Allergy 1992;1:1–72.
15.
La població de Vic: Anàlisi demogràfica i noves tendències de poblament 1975–1991. Ayuntament de Vic, Capellades, 1992.
16.
American Thoracic Society: Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 1987;136:225–244.
17.
Sanhis J, Casan P, Castillo J, González N, Palenciano L, Roca J: Normativa para la práctica de la espirometría forzada. Arch Bronconeumol 1989;25:132–142.
18.
Jones PW, Quirk FH, Baveystock CM, Littlejohns P: A self-complete measure of health status for chronic airflow limitation. The St. George’s Respiratory Questionnaire. Am Rev Respir Dis 1992;145:1321–1327.
19.
Jones PW, Pearson LAM, Stinson JC, Klim JB: The impact of asthma on an employed population (The Zeneca Asthma Study). Eur Respir J 1995;8(suppl 19):153s.
20.
Jones PW, Quirk FH, Baveystock CM: The St. George’s Respiratory Questionnaire. Respir Med 1991;85(suppl B):25–31.
21.
Ferrer M, Alonso J, Prieto L, Plaza V, Monsó E, Marrades R, Aguar MC, Khalaf A, Antó JM: Validity and reliability of the St. George’s Respiratory Questionnaire after adaptation to a different language and culture: The Spanish example. Eur Respir J 1996;9:1160–1166.
22.
V-I. Vademecum Internacional. Madrid, Medicom, 1995.
23.
Burr ML, Charles TL, Roy K, Seaton A: Asthma in the elderly: An epidemiologic survey. BMJ 1979;1:1041–1044.
24.
Quadrelli SA, Roncoroni AJ: Is asthma in the elderly really different? Respiration 1998;65:347–353.
25.
Jones PW: Issues concerning health-related quality of life in COPD. Chest 1995;107:187s– 193s.
26.
Jones PW, Lasserson D: Relationship between change in St. George’s Respiratory Questionnaire score and patient’s perception of treatment efficacy after 1 year of therapy with nedocromil sodium. Am J Respir Crit Care Med 1994;149:A211.
27.
Quirk FH, Jones PW: Patient’s perception of distress due to symptoms and effects of asthma on daily living and an investigation of possible influential factors. Clin Sci 1990;79:17–21.
28.
Mellis CM, Peat JK, Bauman AE, Woolcock AJ: The cost of asthma in New South Wales. Med J Aust 1991;155:522–528.
29.
National Asthma Campaign: 1992. Report on the cost of asthma in Australia.
30.
Action Asthma: The occurrence and cost of asthma. Worthing, Cambridge Medical Publications, 1990.
31.
Teeling-Smith, G: Asthma. London, Office of Health Economics, 1990.
32.
Thompson S: On the social cost of asthma. Eur J Resp Dis 1984;65:185–191.
33.
Jacobson L, Lindgren B: Astma: De samhällsekonomiska kostnaderna. Studier i hälsoekonomi 8. Lund, Lund Universitet, 1995.
34.
Boston Consulting Group: The costs of adult in Canada. Princeton, Communications Media for Education, 1993.
35.
Boston Consulting Group/CRESGE: Asthme: mieux connaître pour mieux traiter. Paris, Glaxo, 1992.
36.
Barnes PJ, Jonsson B, Klim JB: The costs of asthma. Eur Respir J 1996;9:636–642.
37.
Blainey D, Lomas D, Beale A, Partridge M: The costs of acute asthma: How much is preventable? Health Trends 1991;22:151–153.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.