Underdiagnosis and undertreatment of asthma in the elderly
Underdiagnosis and undertreatment of asthma in the elderly
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DOI：
10.1378/chest.116.3.603
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发表时间：
1999-09-01
期刊：
影响因子：
9.6
通讯作者：
Lebowitz, MD
中科院分区：
文献类型：
--
作者：
Enright, PL;McClelland, RL;Lebowitz, MD
目的：为了描述社区老年人样本中哮喘的临床相关性，参与者：来自心血管健康研究的4，581名大于或等于65岁的社区样本。测量：标准化呼吸、睡眠和生活质量（QOL）问题，药物清单，肺功能测定和动态峰值流量。结果：4%的参与者报告了目前的哮喘诊断（明确的哮喘），而另外4%的人报告在过去的12个月内至少有一次喘息发作伴有胸闷或呼吸困难吸烟者和充血性心力衰竭者被排除在随后的分析之外，剩下2，527名参与者。在明确患有哮喘的患者中，40%服用拟交感神经支气管扩张剂，30%吸入皮质类固醇，21%茶碱，18%口服皮质类固醇; 39%未服用哮喘药物。明确或可能患有哮喘的参与者比其他参与者更有可能有哮喘家族史、儿童呼吸系统疾病、工作场所暴露史、运动时呼吸困难、花粉热、慢性支气管炎、夜间症状和白天嗜睡。他们也更有可能报告健康状况不佳，抑郁症状和日常生活活动受限。最近哮喘样症状的参与者的发病率和生活质量的差异不大，谁收到了哮喘的诊断与those who had not.Conclusions：老年人哮喘与较低的生活质量和相当的发病率相比，那些谁没有哮喘症状。哮喘在这一人群中诊断不足，且常与过敏性诱因有关;吸入性皮质类固醇未得到充分利用。
Objective: To describe the clinical correlates of asthma in a community-based sample of elderly persons,Participants: A community sample of 4,581 persons greater than or equal to 65 years old from the Cardiovascular Health Study.Measurements: Standardized respiratory, sleep, and quality-of-life (QOL) questions, a medication inventory, spirometry, and ambulatory peak flow.Results: Four percent of the participants reported a current diagnosis of asthma (definite asthma), while another 4% reported at least one attack of wheezing accompanied by chest tightness or dyspnea during the previous 12 months (probable asthma), Smokers and those with congestive heart failure were excluded from the subsequent analyses, leaving 2,527 participants. Of those who had definite asthma, 40% were taking a sympathomimetic bronchodilator, 30% inhaled corticosteroids, 21% theophylline, and 18% oral corticosteroids; 39% were taking no asthma medications. The participants with definite or probable asthma were much more likely than the others to have a family history of asthma, childhood respiratory problems, a history of workplace exposures, dyspnea on exertion, hay fever, chronic bronchitis, nocturnal symptoms, and daytime sleepiness. They were also more likely to report poor general health, symptoms of depression, and limitation of activities of daily living. There was little difference in the morbidity and QOL of participants with recent asthma-like symptoms who had received the diagnosis of asthma versus those who had not.Conclusions: Asthma in elderly persons is associated with a lower QOL and considerable morbidity when compared with those who do not have asthma symptoms. Asthma is underdiagnosed in this group and is often associated with allergic triggers; inhaled corticosteroids are underutilized.