Do you think asthma is just a childhood affliction? In fact, it affects people of all ages—but whether it's long-standing asthma or adult-onset asthma, this troublesome respiratory disease often goes underdiagnosed or undertreated in many older Americans.

The perception that only kids get asthma may be one reason why it’s often overlooked in older patients, but another is that asthma isn't well understood so diagnosing it can be challenging. Doctors may attribute asthma symptoms such as wheezing to another respiratory illness like chronic obstructive pulmonary disease (COPD) or to heart failure since these conditions have similar symptoms. To complicate matters, some older patients have both asthma and COPD.

What's more, many older people think certain lung disease symptoms—like shortness of breath—are due to aging and don't discuss the symptoms with their doctors. It's essential to get any respiratory problems properly diagnosed. See your doctor if you have any of these symptoms: shortness of breath, difficulty breathing, wheezing, coughing or chest tightness. Asthma symptoms may get worse at night and during physical activity.

Asthma affects 7 percent of people older than 65 and can appear at any time—you can even develop asthma in your 70s or 80s. Asthma in the elderly can be especially serious: When hospitalized for asthma, people older than 65 have a death rate 14 times higher than in asthma patients ages 18 to 35, according to a small study in the May 2012 issue of Annals of Allergy, Asthma & Immunology.

Generally, older asthma patients are hospitalized and visit emergency rooms for asthma-related complications more often than younger patients. And their complications from asthma attacks, such as respiratory failure, are far more dangerous. The researchers reported that older asthma patients were more likely to suffer from diabetes, arthritis, physical pain, hay fever, obesity, poor overall health and significantly worse quality of life. Such coexisting health conditions add to the challenge of effectively managing asthma. Eighty-nine percent of the asthma patients in the study were allergic to mold, pet dander or dust mites.

Older patients also need greater amounts of medication to control their asthma symptoms. Yet, the study found that only 53 percent of older asthma patients used their prescribed inhalers. This may be partly because many elderly patients have difficulty using an inhaler. Poor dexterity or weakness may cause them to use inhalers improperly, resulting in insufficient doses, or to give up on them even though other options like a metered-dose device are available.

If you have asthma, review your treatment plan with your doctor. Know what to do in case of a severe asthma attack. And get your annual flu and pneumonia vaccines to avoid respiratory infections.

Publication Review By: the Editorial Staff at

Published: 17 Jul 2013

Last Modified: 17 Jul 2013