A lot of times, people think of asthma as a childhood disease. It’s true that the breathing condition, which may cause wheezing, coughing or a tight feeling in your chest often starts in childhood.
However, asthma can start at any age and many people who began having asthma as children continue to have symptoms as adults. So asthma affects lots of older people as well. Seniors, in particular, can have unique concerns when it comes to managing their asthma and their overall health.
Asthma is a chronic (long-lasting) lung condition. It makes the airways in your lungs narrow, so it can be hard to breathe. Sometimes it’s serious — it can even be life-threatening. But most people with asthma manage it well and keep their symptoms under control.
James Knepler, MD, an interventional pulmonologist with Banner – University Medicine, said that 4% to 8% of adults over 65 have asthma.
Challenges for seniors with asthma
“As you get older, it can be more complicated to manage asthma,” said Dr. Knepler. “Asthma often affects older patients more than younger people, causing more severe symptoms and decreased function.”
There are a few reasons that’s the case:
- You may have other health conditions, such as heart disease, diabetes or arthritis. So you need to manage asthma alongside them.
- Your lung function naturally decreases with age. Therefore, asthma symptoms might impact you more than they used to.
- You may have COPD (chronic obstructive pulmonary disease). “Asthma and COPD are separate diseases that can affect the lungs. They can occur together – and if they do, treatment can be different,” said Dr. Knepler.
- It can be harder to take medication as prescribed. You may have trouble remembering to take medication every day or using your inhaler.
- You may spend more time indoors. That can mean you’re exposed to more asthma triggers like dust mites or pet dander.
- You may be isolated or feel anxious or depressed and you need to manage the emotional aspects of living with asthma.
How asthma symptoms can affect your life
Many seniors with asthma notice:
- Shortness of breath: You feel like you can’t catch your breath, even when you’re just walking or talking.
- Coughing: Especially at night or early in the morning.
- Wheezing: A whistling or squeaky sound you hear when you breathe.
- Chest tightness: Like something heavy is sitting on your chest.
Living with asthma can make it hard to do things you enjoy, like going for walks or playing with your grandkids. Coughing can make it hard for you to sleep.
You may need to take medication to control asthma, and/or you may need to see your health care provider regularly. Sometimes, your asthma symptoms can be very serious and you may need to call 911.
How asthma is diagnosed
Often, seniors with asthma have had the condition for a long time. But sometimes it starts when you’re older. If you have symptoms of asthma, talk to your health care provider.
“It’s important to get medical advice if you think you have asthma,” said Dr. Knepler. An expert can help you get the right diagnosis, create a personal treatment plan, help you avoid complications, be sure you have the right medicine and monitor your lung health.
These steps can help your provider figure out if you have asthma or another health condition:
- Medical history: Your provider will ask about your symptoms, how often you have them and any patterns you’ve noticed.
- Physical examination: Your doctor will listen to your breathing and check for signs of asthma or other possible causes of your symptoms.
- Lung function tests: For tests such as spirometry, you breathe into a device that records your lung function and measures how well your lungs work.
- Peak flow measurement: You can use a peak flow meter at home to measure how fast you can blow air out of your lungs. It can track your symptoms over time.
- Response to medication: Your health care provider might have you try a drug like albuterol. If it helps, that could mean you have asthma.
- Allergy testing: These tests can find triggers that can make asthma symptoms worse.
- Imaging tests: Chest X-rays or CT scans may rule out other lung conditions.
Asthma triggers and risk factors in seniors
Some triggers can cause asthma symptoms in people of any age:
- Allergens like dust mites, pollen, pet dander and mold.
- Smoke and pollution.
- Respiratory infections like colds and flu.
- Cold, dry air in winter and high humidity in summer.
- Strong odors from perfumes or cleaning products.
- Emotional stress and strong emotions.
Seniors can also find their asthma is triggered by lower lung function, other health conditions or infections, medication interactions and movement. Asthma can also cause memory problems and feeling isolated.
Treatment plans for asthma
You and your provider can work together to come up with an asthma treatment plan that’s right for you. It’s important to follow your treatment plan so you keep your symptoms in check, prevent asthma attacks and emergencies, help your lungs stay healthy and keep doing the things you love.
Your doctor may want you to use an inhaler. With an inhaler, you breathe in the asthma medicine, so it goes directly to your lungs. They come in different types, including metered-dose inhalers (MDIs) and dry powder inhalers (DPIs).
Your provider may also ask you to use a spacer, which is a device attached to your inhaler. Spacers help the medication reach your lungs. They are useful if it’s hard to inhale the medicine from the inhaler at exactly the right time.
It’s important to manage your medications well, which can be tough if you have several different prescriptions.
It can help to:
- Understand what your medications are used for, what dosage you should take and what side effects they could cause.
- Use a pill organizer or reminder app to keep track of your medications.
- Have a routine so you remember to take your medicine.
- Keep a list of your medications and review it at your check-ups.
- Refill your prescriptions early, especially if you’ll be traveling.
Along with medicine, lifestyle changes are an important part of your asthma treatment plan. Here are some steps you can take:
- Choose a balanced diet.
- Get regular physical activity. Work with your doctor on how to manage your asthma and exercise.
- Don’t smoke and avoid secondhand smoke.
- Keep allergens in your home at bay by using allergen-proof covers on pillows and mattresses, regularly cleaning and vacuuming and keeping pets out of the bedroom.
- Reduce stress.
- Stay hydrated.
- Consider getting an air purifier for your home.
- Practice breathing exercises such as belly breathing and pursed-lip breathing if your doctor recommends them.
- Avoid asthma triggers as much as possible.
- Work with your provider to develop an asthma action plan so you know exactly what to do to manage your symptoms.
Recognize when asthma is an emergency
Even with the right treatment plan, you may have an asthma attack or symptoms that need care right away. Getting care quickly can prevent complications and even save your life.
Seek care immediately if you:
- Are gasping for breath.
- See that your lips or fingernails are turning blue.
- Can’t use your inhaler or it’s not making a difference.
- Have chest pain or tightness.
- Feel confused or disoriented.
The bottom line
Seniors with asthma face unique challenges because they may have lower lung function and they may have to manage other health conditions and take a range of medications.
If you’re a senior with asthma, it’s important to work with your primary care provider or pulmonologist to develop a treatment plan that keeps your symptoms under control so you can live your life to the fullest.