Asthma severity, atopic status, allergen exposure, and quality of life in elderly persons

Background: Although asthma can be associated with significant airflow obst ruction in those over the age of 65, it is often underdiagnosed and undertr eated. Objective: To describe severity of asthma, allergy skin test sensitivities, indoor allergen exposures, and the impact on quality of life (QOL) and hea lth status in elderly persons with asthma. Methods: A cross-sectional data analysis with 80 elderly persons with asthm a recruited from medical, geriatric, and allergy/immunology tertiary care c enters. Asthma severity was determined by symptoms and measurements of lung function. House dust specimens were collected from mattresses and bedroom carpets and analyzed separately for the major allergens of house dust, usin g monoclonal antibody-based immunoenzymetric assays. QOL was measured using Juniper's Asthma Quality of Life Questionnaire. Health status was measured using the Short Form Health Survey Medical Outcome Questionnaire which inc luded Ferrans and Powers' Quality of Life Index subscales. Results: Two-thirds of participants had either moderate or severe persisten t asthma. Skin tests to a battery of common airborne allergens were positiv e to at least one allergen in 56 of the 75 participants tested (74.7%). Res ervoir dust allergen levels were often high enough to place participants at risk of symptoms or at risk of developing sensitization. Increased asthma severity was associated with significantly lower QOL and a trend toward dec reased health status. Conclusions: Asthma is a significant chronic problem in the elderly. Atopy was common. Asthma severity impacts on these participants' QOL and health s tatus. Results support interventions aimed at identifying allergens precipi tating attacks and reducing them in the home.