Late -onset asthma and related conditions

Many people develop asthma in their adulthood or old age. They often overlook their symptoms as they have never had asthma or allergy before. Such diseases also do not run in their families. Patients therefore are not alerted to such possibilities and this may cause a delay in recognition and treatment.

To put it simply, asthma symptoms have three major characteristics: “Wheeze, cough and breathless”. Persistent cough at night or during seasonal changes may mislead people to believe that they have caught a bad or serious flu only. As for the elderly, general inactivity may lead them to think that their breathlessness symptoms are due to aging only. Moreover, they may not exert themselves enough to experience “shortness of breath” compared with younger people.

However, asthma may develop during any stage of life: infancy, teenage, adulthood, postmenopausal or even at old age. We still do not have the full answer to the difference in age-onset and it is intriguing that some patients and their families have no history of asthma or allergy at all. Nonetheless, if you have “wheeze, cough, and breathless”, seek medical advice promptly.

Smokers may have similar symptoms of “wheeze, cough ad breathlessness”. They may be suffering from a related condition called Chronic Obstructive Pulmonary Disease (COPD). Doctors need to check their medical records, arrange lung function and Chest XR for further diagnosis. COPD and asthma may also coexist.

In Hong Kong, many elderly people suffered from tuberculosis when they were young. Some of them may end up with bronchiectasis, causing persistent cough, copious sputum production and breathlessness. Local researchers have found that a third of those with bronchiectasis may also suffer from asthma. Lung function tests will be able to tell.

Many drugs commonly used among the elderly may precipitate or mimic asthma. For example, beta-blockers for treating high blood pressure may trigger airway spasm, cause wheeze and breathlessness. The same group of drug is also found in eye-drops treating glaucoma. ACE inhibitors, another common group of medication for high blood pressure, may also lead to protracted cough. So it is important to let the doctors know of your medication history.