THE EPIDEMIOLOGY OF ASTHMA IN THE ELDERLY SUBJECT - A REVIEW OF THE LITERATURE

Increased longevity and the maintenance of autonomy in the elderly has lead to an enlargement of the study asthma beyond 65 years. If the ma jority of published work in the literature concludes there is an exces s mortality in the elderly asthmatic one cannot exclude the possibilit y that this excess mortality is due to the association, at this age, o f asthma with other respiratory problems. This association would also explain the great variations in prevalence reported by different autho rs, from 3 to 6% with notable differences according to the sex. Branch ial reactivity appears to be less linked to allergy after 65 than in t he young subject. In the elderly asthmatic the frequency of a past his tory of allergy and of positive cutaneous tests are weaker than in the young, and there is little difference when compared to the non-asthma tic subject. On the other hand the majority of studies show that smoki ng, respiratory infections, and social class are particularly linked t o asthma beyond the age of 65. Although the data on predictive factors may be rare and contradictory certain published works suggest that de terioration in respiratory function most often precedes the appearance of symptoms suggesting the diagnosis. Many uncertainties remain in re lation to asthma in the elderly. This is because in large part there a re insufficiently specific identifying criteria. There is a need to de velop standardised methods of evaluating respiratory handicap, notably specific data on the quality of life as this would be indispensable i n evaluating the consequence of asthma in the elderly subject.