Clinical characteristics of asthma in the elderly in Argentina

ANAHI YAÑEZ; SUSANA DE BARAYAZARRA; MARCELA SORIA; NANCY RECUERO; EDGARDO JARES; ANA MARIA STOK; CARLOS BUENO

Buenos Aires

Congreso; XVIII Congreso Latinoamericano de Alergia, Asma e Inmunología - Slaai 2015; 2015

Sociedad Latinoamericana de Alergia, Asma e Inmunología

Background: Few studies have focused on the characteristics of asthma in the elderly(AIE). Our study reflects the characteristics of old adults living in Argentina who havebeen diagnosed with asthma.Methods: An observational descriptive study was performed at five different healthcare centers in Argentina. Clinical records during three months in 2014 were searched. Allergists reviewed all clinical histories and elderly population was defined as older than 60 years old. Clinical and laboratory characteristics were assessed, including severity of asthma (according to GINA), current treatment, medical and allergic comorbidities, evidence of sensitization via skin prick test (SPT), total serum IgE and elative eosinophil counts Results: Total 152 patients were included and their average age (SD) was 66.83 years (6.52), 73% women, 78% Caucasian and 22% Hispanic. Late onset asthma (asthma onset 60 years old) was observed in 10 % of the patients with average age of 69.67 SD (6.81) years. Regarding severity 73% was diagnosed with persistent asthma and a significant 8% presented severe asthma. Most of the patients were treated with an inhaled corticosteroid (ICS) + long-acting beta-adrenergic (fluticasone + salmeterol 59%), and the first choice as acute reliever therapy was an inhaled fast-acting beta-adrenergic agonist (salbutamol 89%). The doses of ICS were below 1000 mg/day in 77 % of the patients. Arterial hypertension was the most frequent comorbidity (46%), followed by allergic comorbidities (23%). Among allergic comorbidities, patients presented mainly chronic rhino sinusitis (13.8%), seasonal rhinitis (16%) and perennial rhinitis (16%), and chronic rhino sinusitis and perennial rhinitis together (18%). Common sensitizing allergens (SPT) included mites (23%), fungi (12%) and pollens (10%). Triggers were predominantly tobacco smoke (74%), aeroallergens (39%) and exercise (38%). Elevated IgE was found in 54% of patients and increased eosinofilia in 64% of patients. Conclusions: This is a retrospective study about AIE in Argentina that shows the clinical characteristics of this specific age group. A better understanding of the disease is needed to improve its management.