Article

Perception of bronchocon-striction in elderly asthmatics

Department of Chest Diseases, Faculty of Medicine, Kirikkale University, Turkey.
Journal of Asthma (Impact Factor: 1.83). 12/2001; 38(8):691-6. DOI: 10.1081/JAS-100107547
Source: PubMed

ABSTRACT The impaired perception of bronchoconstriction in asthmatic patients may increase the risk of severe exacerbation. To characterize the perception of bronchoconstriction in elderly asthma patients, we compared the perception in older patients with that of younger patients. To determine the influence of perception of long-standing diseases, we further evaluated the perception in early-onset elderly asthma patients and in late-onset elderly asthma patients. The study group consisted of 80 stable asthmatic patients. The patients were grouped according to their age (group 1, < 60 years, n = 37, group 2, > or = 60 years, n = 43). Each group was separated into two subgroups according to the duration of symptoms (late-onset asthma 1A and 2A, < 5 years, early-onset asthma 1B and 2B, > or = 5 years). A histamine inhalation test was performed for each patient. Dyspnea was assessed by modified Borg scale. The Borg score in forced expiratory volume in 1 sec (FEV1) reduction by 20% was determined as perception score 20 (PS20). The mean perception scores of the elderly asthmatic patients were significantly lower than those of the younger asthmatic patients (group 1, PS20 = 2.35 +/- 0.17; group 2, PS20 = 1.37 +/- 0.12, p < 0.0001). The differences of mean perception score (PS20) between early- and late-onset subgroups were insignificant (IA, 2.63 +/- 0.30 and IB, 2.07 +/- 0.16, p = 0.101; 2A, 1.36 +/- 0.19 and 2B, 1.59 +/- 0.120, p = 0.91). The mean perception scores of male asthmatic patients were significantly lower than those of female patients (p = 0.03). There was a correlation between PS20 and % FEV1 in the younger group (r = 0.392, p = 0.02), but not in the elderly group (r = 139, p = 0.375). The correlation between PS20 and PD20 in both younger and elderly group was insignificant (p > 0.05). Elderly asthmatics perceive less intense respiratory distress for a decrease of 20% in FEV1 than do younger asthmatics. This underperception of bronchoconstriction may result in a delay in medical care during an acute asthmatic episode. Thus, we strongly recommend that elderly asthmatic patients should be followed up more frequently and closely.

Download full-text

Full-text

Available from: Alpaslan Apan, May 04, 2015
0 Followers
 · 
75 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To find out whether symptom-free asthmatic patients with impaired lung function, improve with regard to quality of life after treatment adjustment. Forty-two primary care asthma patients without symptoms were divided into two groups: (A) with normal lung function (n=22); and (B) with impaired lung function (n=20). Lung function, symptoms and quality of life were assessed before and after a 3-month interval. In group B (but not in group A), treatment was adjusted on the first visit. Quality of life was significantly worse in group B at visit 1 and was improved up to the same level as in group A after 3 months of treatment adjustment. Quality of life did not change in group A during the 3 months of observation. Lung function improved significantly only in group B but did not reach the same level as in group A. Adjustment of therapy improves quality of life even in patients who do not experience symptoms. Asthma treatment should therefore be guided by both symptoms and lung function.
    Primary Care Respiratory Journal 04/2004; 13(1):42-7. DOI:10.1016/j.pcrj.2003.11.012 · 2.91 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Monitoring asthma outcomes is an essential step to the successful implementation of national asthma guidelines. Symptoms, airflow obstruction and exacerbations can be monitored by patients with asthma and by physicians. Patients who practise self-monitoring in conjunction with use of a written action plan and regular medical review have significantly fewer hospitalizations, emergency room visits and lost time from work. Additional monitoring tools are under evaluation, and these include measures of airway responsiveness, airway inflammation, and Internet-based monitoring systems.
    Current Opinion in Allergy and Clinical Immunology 07/2002; 2(3):161-6. DOI:10.1097/00130832-200206000-00002 · 3.66 Impact Factor
  • Immunology and Allergy Clinics of North America 11/2002; 22(4):753-789. DOI:10.1016/S0889-8561(02)00022-X · 2.22 Impact Factor