Characterization of elderly and non-elderly patients with bronchial asthma

• Autor(a) principal: Ferreira, Gonçalo Rafael Marques
• Data de Publicação: 2016
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.6/5348
• topic: Asthma Control; Asthmatic; Bronchial Asthma; Elderly; Non Elderly; Domínio/Área Científica::Ciências Médicas::Ciências da Saúde::Medicina

Background: Asthma control is harder to assess in elderly asthmatics due to the presence of co-morbidities that can mimic asthma symptomatology and due to the lack of perception of asthma symptoms on the part of the patients. Moreover, impairment of cognitive functions and decrease of lung function due to aging also contribute to the flawed control assessment in this age group. This study aims to assess asthma control as well as its impact on the quality of life in elderly and non-elderly asthmatics, and to find out predictors of poor asthma control in these two age groups of asthmatics. Methods: Cross-sectional assessment of a sample of 92 elderly and 100 non-elderly patients with the clinical diagnosis of Bronchial Asthma being followed up at Centro Hospitalar Cova da Beira, Covilhã, Portugal. All volunteers signed a written informed consent form. Clinical and sociodemographic data were collected first and then standardized and validated questionnaires were used to evaluate depression, cognitive state, asthma control, quality of life and knowledge about the disease. Assessment of inhaler technique by the patients was also carried out. Results were analysed using the Software Package for Social Sciences®, version 23.0. Results: The majority of the asthmatics were well controlled according to ACT and partially controlled according to GINA. When control was studied using CARAT in elderly asthmatics with allergic rhinitis, most of them were not controlled. Non-elderly patients with well controlled and partially controlled asthma had better quality of life than well controlled and partially controlled elderly patients. Regarding predictors of poor control on EA, higher Graffar class and exposure to tobacco smoke were predictors of poor control on CARAT lower airways component and global components, respectively. For the NEA, higher Graffar class and higher number of exacerbations in the last year were predictors of poor control on the CARAT and ACT, respectively. Conclusions: Although most of the patients were at least partially controlled, those with concurrent rhinitis have worse asthma control. When compared to non-elderly asthmatics, elderly patients have similar levels of control, although their quality of life tends to be worse than in younger patients. In terms of factors that predict worse asthma control, low socioeconomic status may be a predictor of poor asthma and allergic rhinitis control in the two age groups and exposure to tobacco smoke may also be a predictor of worse control in elderly asthmatics with rhinitis.