Asthma in older adults presents some special concerns. For example, the normal effects of aging can make asthma harder to diagnose and treat. So can other health problems that many older adults have (like emphysema or heart disease). Also, older adults are more likely than younger people to have side effects from asthma medicines. (For example, recent studies show that older adults who take high doses of inhaled steroid medicines over a long time may increase their chance of getting glaucoma.)When some asthma and non-asthma medicines are taken by the same person, the drugs can combine to produce harmful side effects. Doctors and patients must take special care to watch out for and address these concerns through a complete diagnosis and regular checkups.
To help you understand what asthma does, consult:
Asthma Tutorial
Asthma & Wheezing
It is important to note that any difficulty with breathing should be evaluated by a physician as these symptoms could represent many different illnesses.
In addition to a pulmonary function test, doctors may give blood or skin allergy tests if asthma is suspected, especially if a specific allergen or occupational agent is the suspect cause of the asthma. Allergy skin tests are the best method for predicting allergic asthma.In general treatments include avoiding precipitating factors, utilizing medications to prevent asthma attacks (such as inhaled steroids), and using quick acting medications for sudden attacks. Doctors usually treat asthma with bronchodilators (drugs that help dilate the lungs’ constricted airways). Bronchodilators may be taken orally or inhaled. Inhaled bronchodilators come in aerosol or metered-dose inhaler form. Doctors usually prefer to prescribe the inhaled bronchodilators because they deliver the medication directly to the lungs. One to two puffs generally relieves the wheezing and chest tightness associated with episodes of asthma.
Accurate diagnosis is important because asthma is treated differently from other diseases with similar symptoms. Talk openly with your doctor and say what you want to be able to do that you can't do now because of your asthma. Also, tell your doctor your concerns about your asthma, your medicines, and your health.
If you take medicine that you must inhale, be sure that you are doing it right. It must be timed with taking your breath in. And such common problems as arthritis or loss of strength may make it more difficult. There are many different types of inhalers available, so it is important that you are able to use the inhaler properly. Talk to your doctor if you are having problems with the use of the inhaler.
It's also important to talk to your doctor about all the medicines you take—for asthma and for other problems—to be sure they will not cause harmful side effects. Be sure to mention eye drops, aspirin, and other medicines you take without a prescription.
Finally, be honest about any problems you may have hearing, understanding, or remembering things your doctor tells you. Ask your doctor to speak up or repeat something until you're sure of what you need to do. Watch for early symptoms and respond quickly. Your doctor also may want you to use a "peak flow meter," which is a small plastic tool that you blow into that measures how well you are breathing. If you respond quickly to the first signs that your asthma is getting worse, you can prevent serious asthma attacks.
See your doctor at least every six months to update your condition. To treat asthma correctly, it is imperative that you have a treatment plan that describes what to do for various symptoms and when to call the doctor or go to an emergency room. It is imperative that you know your baseline peak flow. It is imperative that you correctly use any inhaled medication. Bring your treatment plan and all your medicines to every checkup. Show your doctor how you take your inhaled medicines to make sure you're doing it right.
Prevention/Helpful Advice:
- Avoid triggers like tobacco smoke, viruses, pollen
- Put allergy covers (i.e., dust mite-proof) on your mattress and pillows.
- Wash your sheets in hot water (130oF) every week to control dust mites.
- Use an air conditioner during the summer.
- Maintain low indoor air humidity (below 50%).
- Clean molds from wet areas.
- Remove pets from your home (especially from your bedroom).
- Ask about getting a flu shot and a vaccine to prevent pneumonia.
- See your doctor at least every 6 months. You may need to go more often, especially if your asthma is not under control.
- Ask your doctor for a written treatment plan and then be sure to follow it. A written treatment plan will tell you when to take each of your asthma medicines and how much to take. If you have trouble reading small print, ask for your treatment plan (and other handouts) in larger type.
For more information, see:
Asthma--Basics, Care, and Prevention
Living with Asthma (Journal of the American Medical Association) (PDF document)
Taking Control: A Guide for People with Asthma
