Asthma & the Older Adult Series: Getting the Right Diagnosis
For most of this century, asthma has largely been thought of as a kids' disease. And, while it's true that more than 6 million kids in the United States alone may have asthma, asthma can come on at any age... including in the senior years. In fact, asthma in adults over the age of 65 has been growing by leaps and bounds the past couple of decades. And many cases of older adult-onset asthma go undiagnosed at all.
Some older adults with asthma have been living with it all their lives, or at least for many years. But it is also possible to actually develop asthma for the first time after the age of 65. This post will look at the issue of getting an asthma diagnosis as an older adult.
Causes of Asthma in Older Adults
People are living longer than ever these days. That makes them more susceptible to chronic illness, one of which is asthma. Asthma in children is usually linked to allergic disease, but in older adults, it can be more related to environmental causes.
The diagnosis of asthma in an older adult often doesn't happen, at least not on a timely basis. And that's unfortunate, because by the time it is diagnosed, respiratory health has often greatly deteriorated. So, why is asthma so hard to diagnose in the older adult?
Reasons for Underdiagnosis of Asthma in Seniors
- Symptoms can be similar to other common diseases of aging. Heart disease, COPD and Acid Reflux (or GERD) and generally deteriorating health and more frequent upper respiratory infections can all blur the line with asthma. Both the older adult and his or her doctor may incorrectly assume symptoms are due to one of these other conditions.
- Accompanying allergic diseases common with childhood asthma are often not present in older adults with asthma. Nasal allergies and skin allergies are commonly associated with asthma in kids. But the same is not true for older adults. Only about half of older adults with asthma also have allergies.
- Older adults may be more accepting of symptoms and fail to report them until their next visit to the doctor. When kids are sick, parents generally scramble to get medical attention so they can get better. But when an older adult feels a bit "under the weather," he or she may just think, "Oh, it's just part of getting older..." and fail to follow up on symptoms quickly.
Important Facts About Asthma in Seniors
It's important, though, to get that asthma diagnosis if you're over the age of 65. Studies show that people over the age of 65 who have asthma are much more prone to severe asthma symptoms and asthma attacks. They also are more likely to die from asthma than younger people are.
Asthma is more common in older women than it is in older men. Experts aren't sure why, but it could be tied to hormonal changes during and after menopause.
Getting an Asthma Diagnosis
It will take teamwork between you and your doctor to get that asthma diagnosis! If you notice any of the following symptoms, they might be due to asthma and should definitely be discussed with your doctor at your first opportunity:
- Chronic cough, especially while sleeping
- Wheezing, a whistling sound when you breathe out and in
- Shortness of breath
- Chest tightness, feeling as though you can't breathe in deeply
- Frequent colds that "go to your chest" or hang on for 10 days or more
When you go in to see your doctor, he or she will want to know more about how those symptoms feel exactly, when they occur, what you were doing beforehand and what -- if anything -- helps relieve them. So starting to keep a written diary of all that information can really be helpful to your doctor.
Your doctor will need to examine you, listening to your breath sounds and your lungs with a stethoscope. You may also be asked to breathe into something called a peak flow meter. This is a small device that measures how forcefully you can exhale. That can tell the doctor a lot about whether asthma might be your diagnosis. Another respiratory test called spirometry may also be ordered. Chest x-rays cannot show asthma, but they may help rule out other lung problems, so your doctor might order those too. In addition, your doctor may decide to test you for allergies.
Two other respiratory diseases that can be confused with asthma are chronic obstructive pulmonary disease (COPD for short) and chronic bronchitis. Though similar in some respects, all 3 diseases are separate entities. You might even have 2 of them at the same time. But it's important to understand the difference.
Next up in this series on asthma in the older adult is a discussion of asthma management in seniors.
This Post:Getting the Right Diagnosis
Part 3: Staying Healthy as an Older Adult With Asthma