DIFFERENTIAL-DIAGNOSIS OF BRONCHIAL-ASTHMA IN THE ELDERLY

Asthma is very common in the elderly, with a prevalence of about 7% to 9%. Since many patients with asthma either currently smoke cigarettes or have in the past, they frequently haved mixed disease with feature s of both asthma (reversible airflow obstruction) and COPD (fixed airf low obstruction). Since patients with COPD often have a reversible com ponent to their condition, asthma medications may relieve some symptom s and improve the patient's quality of life. The differential diagnosi s of asthma in the elderly needs to take into account not just COPD, b ut also other pulmonary conditions such as upper airway obstruction (U AO), interstitial lung disease (ILD), bronchiectasis, pulmonary emboli sm (PE), and bronchogenic carcinoma. Asthma also needs to be distingui shed from nonpulmonary diseases, particularly cardiovascular and gastr ointestinal diseases. Finally, it is essential to differentiate the no rmal, psychologic, and psychosocial changes that accompany aging proce sses from abnormal changes that accompany age-associated diseases such as asthma.