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Elderly asthma patients had greater airway involvement than younger patients

Elderly patients with asthma had greater involvement with small and large airways and less atopy than patients aged 65 years or younger with asthma, according to recent study results.

Researchers in Japan conducted a retrospective analysis on 45 elderly patients (aged more than 65 years) with asthma (mean age, 73.1 years; 34 women; median disease duration, 12.7 years) and 67 nonelderly patients with asthma (mean age, 48.6 years; 46 women; median disease duration, 8 years). Spirometry, computed tomographic indices of large airway wall thickness and small airway involvement, impulse oscillation measurements, exhaled nitric oxide levels, blood and induced sputum cell differentials, methacholine airway responsiveness and serum gE levels were used.

There were significantly lower values for forced expiration volume in 1 second (median 81.2% vs. 88.8%; P=.02), mid-forced expiratory flow (percentage predicted; 50.9% vs. 78.6%; P=.03) and the ratio of forced expiration volume in 1 second to forced vital capacity (0.72 vs. 0.78; P=.001) in the elderly patients compared with the nonelderly patients. Elderly patients also had significantly greater airway wall thickening and air trapping.

“Impulse oscillation measurements indicated that elderly patients with asthma showed significantly greater resistance at 5 Hz, greater decrease in resistance from 5 to 20 Hz, a higher ratio of decrease in resistance from 5 to 20 Hz to resistance at 5 Hz, higher integrated area between 5 Hz and frequency of resonance, greater frequency of resonance and lower reactance at a frequency of 5 Hz (potential markers of small airway disease) than nonelderly patients,” the researchers wrote.

Neither patient cohort experienced significant differences in sputum or blood cell differentials, exhaled nitric oxide or methacholine airway responsiveness. The elderly cohort had significantly lower levels of total serum IgE and positive rates of specific IgE antibodies against multiple allergens compared with the younger patients.

“Despite some limitations, these results may provide a better understanding of the pathophysiology and future therapeutic strategies for asthma in the elderly,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.