Asthma and COPD

Enright, Paul; Fragoso, Carlos A. Vaz

Asthma and chronic obstructive pulmonary disease (COPD) are clinically important in older adults because like heart failure, they are common causes of chronic shortness of breath, which reduces the quality of life by limiting an individual’s activity. In developed countries, about 4% of older adults have been diagnosed with asthma and another 4% have been diagnosed with COPD, but the prevalence is doubled for each of these chronic respiratory diseases when objective tests are performed. COPD has become the fourth leading cause of death in some developed countries. COPD onset occurs almost exclusively in older age due to the cumulative effects of cigarette smoking in genetically-susceptible individuals. An upper respiratory viral infection commonly leads to the initial diagnosis of asthma at any age. About half of older adults with asthma have allergic triggers, compared to about 90% of asthmatic children. Exacerbations with dyspnea, wheezing and cough are the major morbidity of asthma and COPD, which limits activity, reduces quality of life and increases health care utilization and costs. In older adults as in younger adults, the most effective prevention for both asthma and COPD is smoking cessation.