Asthma...At my age!

While asthma is more frequent in children and young adults, asthma can affect people at ANY age. Over 2 million people age 65 and older have asthma in the US. The symptoms of asthma are similar regardless of age and include recurrent cough, wheezing, chest tightness and/or shortness of breath.

Have you heard an adult say, “I had asthma as a child, but I outgrew it”? If you had asthma when you were younger, it can return! The return of symptoms is easily overlooked as bronchitis and may delay the diagnosis of asthma and therefore appropriate treatment.

Asthma can develop for the first time as an adult. About 20% of adult-onset asthma is caused by or worsened at the workplace. This is called Occupational Asthma or Work-Related Asthma. Certain occupations where there are sensitizing chemicals or allergens carry a higher risk. These occupations can include: carpenters, saw mill workers or furniture makers, painters, veterinarians, lab workers, fish processing, chefs/bakers, electronic workers, hospital workers, welders, farmers, factory workers, and more. Over 300 agents in the workplace can trigger asthma. Many Americans are working beyond the usual age of retirement or starting hobbies that expose them to allergens or irritants.

Triggers of asthma in the older generations include:

• Exercise: some individuals attribute shortness of breath during exercise to “being overweight and out of shape” (your doctor may call this “deconditioning”). While this may be true, it doesn’t mean you don’t have asthma. Asthma is more common in overweight people and some people avoid exercise as this triggers their symptoms.

• Cold air, air pollution/smoke, respiratory infections, allergies and sinus infections: while allergies are commonly thought of as a young person’s affliction, I have treated many patients who developed allergies well into their 8^th decade.

• Medications may trigger asthma. Beta-blockers used for treating high blood pressure or migraines. Aspirin can lead to severe asthma symptoms in a small percentage of adults. ACE inhibitors used to treat high blood pressure may trigger cough, but not necessarily asthma, even if the medication has been tolerated for many months.

Other diseases that can cause breathing problems in seniors include:

• Chronic bronchitis and emphysema (known as COPD). This is especially common in persons who smoked.

• Congestive heart failure: fluid builds up in the lungs and the feet/ankles

• Heart attack: myocardial infarction (lack of oxygen to heart muscle) can cause shortness of breath and chest pain

• Pulmonary embolism: blood clot in the lungs leads to immediate and severe shortness of breath or recurrent symptoms if blood clots are small and breaking loose from the leg veins.

• Pneumothorax: an air leak where air from the lungs becomes trapped between the chest wall and outer part of the lungs. This can be serious and can be seen on a chest x-ray.

• Atelectasis: This is when the small airways of the lungs collapse or even an entire lobe of the lung collapses. A variety of conditions can lead to atelectasis.

• Other causes: anemia, aspiration, tumors, inflammatory conditions (sarcoid), obesity, muscle weakness, anxiety, infections (pneumonia), pulmonary hypertension (increased blood pressure in the blood vessels in the lungs), interstitial lung diseases (hypersensitivity pneumonitis, pulmonary fibrosis and others) and the list goes on.

At Family Allergy Asthma & Sinus Care, we take care of patients of all ages with asthma and allergic disorders. Asthma can occur at any age and through appropriate diagnosis and treatment, asthma can be controlled, so you can lead a full and productive life into those “golden years.”