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Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

ABSTRACT: BACKGROUND:Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. OBJECTIVE:The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control. METHODS:Data were obtained from 14,076 older adults ?65 years with active asthma participating in the 2006-2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey (a random-digit dialed survey) in 40 US states, the District of Columbia, and Puerto Rico, representative of >2.6 million persons. Weighted, adjusted logistic regression was conducted. RESULTS:One or more asthma-related hospitalizations in the past year were reported by 5.7% (95% confidence interval [95% CI] = 5.0% to 6.4%) of participants; 10.6% (95% CI = 9.7% to 11.5%) reported ?1 asthma-related ED/UCV. Compared with older adults without asthma-related hospitalizations, adjusted odds were higher among those with ?1 asthma-related hospitalization for chronic obstructive pulmonary disease (COPD), coronary artery disease, depression, cockroaches or mold in the home, and cost barriers to asthma-related health care or medication. All these factors, except for cockroaches, were associated with asthma-related ED/UCV. Compared with males, adjusted odds were higher among females for COPD, depression, obesity, and cost barriers to asthma-related health care or medication. CONCLUSIONS:Among older adults, asthma-related hospitalizations and ED/UCV were associated with clinical comorbidities, mold in the home, and financial barriers to asthma-related health care. Interventions addressing modifiable factors could reduce asthma morbidity among older adults.

SUBMITTER: Hsu J

PROVIDER: S-EPMC5760447 | biostudies-literature | 2018 Jan - Feb

REPOSITORIES: biostudies-literature

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Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

Hsu Joy J Chen Jessica J Mirabelli Maria C MC

The journal of allergy and clinical immunology. In practice 20170726 1

<h4>Background</h4>Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described.<h4>Objective</h4>The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to ...[more]

PMID: 28756082

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Project description:BackgroundThis study investigated the sex-specific incidence of asthma and the effects of modifiable risk factors, particularly obesity, on asthma incidence among middle-aged and older individuals in Korea.MethodsWe used data from the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS), which includes health examinees aged 40-79?years in 2002-2003. In total, 459,529 participants with baseline anthropometric measurements were followed-up for 10?years and the development of asthma was evaluated (2004-2013). For subgroup analysis, 246,019 participants who had body mass index (BMI) and waist circumference (WC) measurements taken in 2008-2009 were included in the analysis of the asthma incidence for 2010-2013. Factors associated with asthma were analysed using Cox proportional hazard models.ResultsThe cohort comprised 4,248,813 (men, 2,358,541; women, 1,890,272) person-years of follow-up for 2004-2013. The asthma incidence was 10.58 and 15.03 per 1000 person-years for men and women, respectively. Asthma incidence increased with age, notably so in men. Obesity based on the baseline BMI was significantly associated with asthma development in both sexes (men, HR?=?1.23, 95% confidence interval (CI)?=?1.13-1.34; women, HR?=?1.40 95% CI?=?1.32-1.48). High WC was also related to asthma incidence in both sexes with statistical significance (men, HR?=?1.34, 95% CI?=?1.16-1.57; women, HR?=?1.19 95% CI?=?1.03-1.37). Analysis of the combined effects of BMI and WC showed that men had a higher asthma risk in the group with both general obesity and abdominal obesity than in the group with non-abdominal obesity and normal BMI. However, obese women had a higher risk of asthma regardless of abdominal obesity. Similarly, smoking was associated with asthma in both sexes but drinking and physical activity showed different associations between the sexes.ConclusionsOur results revealed that asthma incidence was substantially high at old age and lifestyle factors were associated with asthma development. Practical strategies including weight control and healthy lifestyle modification are required to prevent asthma in older people.

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Dataset Information

Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

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Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

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