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Outcome measures to be considered on asthma in elderly

Gonzalez-Diaz, Sandra Noraa; Villarreal-Gonzalez, Rosalaura Virginiaa,b; Lira-Quezada, Cindy Elizabeth Dea,b; Guzman-Avilan, Rosa Ivetta,b

Current Opinion in Allergy and Clinical Immunology: February 8, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/ACI.0000000000000525
REVIEW: PDF Only

Purpose of review Asthma is a chronic heterogeneous respiratory disease which is characterized by airflow limitation and variable respiratory symptoms. Asthma in patients more than 65 years of age has an important negative impact on quality of life. The pathophysiology and treatment of asthma in older patients are not as well identified as in younger groups of ages. In this review we intend to outline characteristics found in elderly adults which distinguish them from other age groups of patients with asthma.

Recent findings With increasing age, there are alterations in the innate and adaptive immune responses, known as ‘immunosenescence.’ These age-associated modifications include an altered response after a pathogenic exposure or tissue injury, moderately mediated through an irreversible loss of cellular replication and defective tissue repair.

Summary Asthma is a consequence of complex gene–environment interactions, with diversity in clinical presentation and the type and intensity of airway inflammation and remodeling. Age-associated changes in lung physiology and morphology may occur and contribute to asthma. Aging is correlated with a notable decrease in elastic recoil, greater chest wall rigidity, and poor respiratory muscle strength. Underreporting of symptoms by elderly patients is common because of multiple underlying causes.

Video abstract http://links.lww.com/COAI/A17.

aRegional Center of Allergy and Clinical Immunology, Universidad Autonoma de Nuevo León

bWorld Allergy Organization Center of Excellence; Facultad de Medicina, University Hospital ‘Dr José Eleuterio González,’ Monterrey, Nuevo León, Mexico

Correspondence to Sandra Nora Gonzalez-Diaz, MD, PhD, Monterrey, Nuevo León, Mexico. Tel: +52 (818) 348 2459; e-mail: sgonzalezdiaz@yahoo.com

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