FacebookTwitter

 

Artículo de Revisión

Asma en adultos mayores

Anahí Yáñez, Carlos Bueno

Revista Fronteras en Medicina 2016;(4):0140-0145 


El asma se ha considerado a menudo como una enfermedad cuyo inicio se produce en la infancia. Sin embargo, recientes estudios poblacionales han informado que el inicio del asma es común en las personas mayores.
La carga sanitaria, personal y económica del asma puede ser más significativa en los ancianos que en sus homólogos más jóvenes, particularmente en lo que se refiere a la mortalidad, la hospitalización, los costos médicos o la calidad de vida relacionada con la salud.
El asma en el Adulto Mayor (AAM) sigue siendo subdiagnosticada y subtratada.
El objetivo principal de esta Revisión es identificar las necesidades no satisfechas en los campos de investigación y práctica para AAM, así como encontrar nuevas direcciones de investigación, proponer nuevas estrategias terapéuticas y mejorar los resultados para el creciente número de personas mayores con asma.
El desafío de hoy es fomentar la investigación en AAM, utilizando el conocimiento existente para mejorar el diagnóstico, y los diagnósticos deferenciales, así como educar al paciente, desarrollar un enfoque terapéutico seguro y eficaz, controlar la enfermedad y, finalmente, proporcionar una mejor calidad de vida.


Palabras clave: edad, asma en adulto mayor, alergia, envejecimiento,

Asthma has often been considered as a childhood disease. However, recent population studies reported that asthma is common in the elderly
The burden of asthma may be more significant in the elderly than in their younger counterparts, particularly with regard to mortality, hospitalization, medical costs or health-related quality of life.Asthma in the Elderly (AIE) is still under-diagnosed and under-treated.
The primary aim of this review is to identify unmet needs in the fields of research and practice for AIE. This will enable us to find new research directions, propose new therapeutic strategies, and ultimately improve outcomes for elderly people with asthma.
The challenge today is to encourage new research in AIE, but to already use existing knowledge we have to make the diagnosis of AIE, educate the patient, develop a therapeutic approach to control the disease, and ultimately provide a better quality of life to our elderly patients


Keywords: age, asthma in the elderly, allergy, ageing,


Los autores declaran no poseer conflictos de intereses.

Fuente de información Hospital Británico de Buenos Aires. Para solicitudes de reimpresión a Revista Fronteras en Medicina hacer click aquí.

Recibido | Aceptado | Publicado 2016-12-30

Tabla 1. Lista sugerida de preguntas pendientes de respuestas clínicas sobre el asma en el adulto ...

  1. Kim YK, Kim SH, Tak YJ, Jee YK, Lee BJ, Park HW, et al. High prevalence of current asthma and active smoking effect among the elderly. Clin Exp Allergy 2002;32:1706-12.

  2. Parameswaran K, Hildreth AJ, Chadha D, Keaney NP, Taylor IK, Bansal SK. Asthma in the elderly: underperceived, underdiagnosed and undertreated; a community survey. Respir Med 1998;92:573-7.

  3. Soriano JB, Kiri VA, Maier WC, Strachan D. Increasing prevalence of asthma in UK primary care during the 1990s. Int J Tuberc Lung Dis 2003;7:415-21.

  4. Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, Scalia MR, Akinbami LJ. National surveillance for asthma–United States, 1980–2004: Department of Health and Human Services, Centers for Disease Control and Prevention. 2007.

  5. Bellia V, Pedone C, Catalano F, Zito A, Davì E, Palange S, et al. Asthma in the elderly, mortality rate and associated risk factors for mortality. Chest 2007;132:1175-82.

  6. Hanania NA, King MJ, Braman SS, Saltoun C, Wise RA, Enright P, et al. Asthma in Elderly workshop participants: Asthma in the elderly: Current understanding and future research needs—a report of a National Institute on Aging (NIA) workshop. J Allergy Clin Immunol 2011;128:S4-S24.

  7. Enright PL, McClelland RL, Newman AB, Gottlieb DJ, Lebowitz MD. Underdiagnosis and undertreatment of asthma in the elderly. Cardiovascular Health Study Research Group. Chest 1999;116:603-13.

  8. Bauer BA, Reed CE, Yunginger JW, Wollan PC, Silverstein MD. Incidence and outcomes of asthma in the elderly. A population-based study in Rochester, Minnesota. Chest 1997;111:303-10.

  9. Yáñez A, Cho SH, Soriano JB, Rosenwasser LJ, Rodrigo GJ, Rabe KF, et al. Asthma in the elderly: what we know and what we have yet to know. World Allergy Organ J 2014;7(1):8.

  10. Arif A, Delclos G, Lee E, Tortolero SR, Whitehead LW. Prevalence and risk factors of asthma and wheezing among U.S. adults: an analysis of the NHANES III data. Eur Respir J 2003;21:827-33.

  11. Moorman J, Rudd R, Johnson C, King M, Minor P, Bailey C, Scalia MR, AkinbamiLJ: Centers for Disease Control and Prevention (CDC). National surveillance for asthma- United States 1980–2004. MMWR Surveill Summ 2007;56:1-54.

  12. Bauer BA, Reed CE, Yunginger JW, Wollan PC, Silverstein MD. Incidence andoutcomes of asthma in the elderly: a population-based study in Rochester, Minnesota. Chest 1997, 111:303-10.

  13. Jarvis D, Luczynska C, Chinn S, Burney P. The Association of Age, Gender and Smoking with Total IgE and Specific IgE. Clin Exp Allergy 1995;25(11):1083-91.

  14. Barbee RA, Kaltenborn W, Lebowitz MD, Burrows B. Longitudinal Changes in Allergen Skin- Test Reactivity in A Community Population-Sample. J Allergy Clin Immunol 1987;79(1):16-24.

  15. Reed CE. The natural history of asthma. J Allergy Clin Immunol 2006;118(3):543-8.

  16. King MJ, Bukantz SC, Phillips S, Mohapatra SS, Tamulis T, Lockey RF. Serumtotal IgE and specific IgE to Dermatophagoides pteronyssinus, but not eosinophil cationic protein, are morelikely to be elevated in elderly asthmatic patients. Allergy Asthma Proc 2004; 25(5):321-5.

  17. Huss K, Naumann PL, Mason PJ, Nanda JP, Huss RW, Smith CM, Hamilton RG. Asthma severity, atopic status, allergen exposure, and quality of life in elderly persons. Ann Allergy Asthma Immunol 2001;86(5):524-30.

  18. Kawamatawong T, Siripongpun S, Rerkpattanapipat T. Role of eosinophilic inflammation and atopy in elderly asthmatic patients. Asia Pac Allergy 2016;6(3):181-6.

  19. Zein JG, Dweik RA, Comhair SA, Bleecker ER, Moore WC, Peters SP, Busse WW, Jarjour NN, Calhoun WJ, Castro M, Chung KF, Fitzpatrick A, Israel E, Teague WG, Wenzel SE, Love TE, Gaston BM, Erzurum SC. Severe Asthma Research Program. Asthma Is More Severe in Older Adults.. PLoS One 2015;10(7):e0133490.

  20. Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD). 2015 Asthma, COPD and Asthma-COPD Overlap Syndrome (ACOS) ttp://ginasthma.org/asthma-copd-and-asthma-copd-overlap-syndrome-acos/

  21. Reed C. Asthma in the elderly: Diagnosis and management. J Allergy Clin Immunol 2010, 126:681-7.

  22. Scichilone N, Messina M, Battaglia F, Catalano Fand Bellia V. Airway hyperresponsiveness in the elderly: prevalence and clinical implications. Eur Respir J 2005, 25:364-75.

  23. Cazzola M, Calzetta L, Bettoncelli G, Novelli L, Cricelli C, Rogliani P. Asthma and comorbid medical illness. Eur Respir J 2011; 38:42-9.

  24. Sano H, Iwanaga T, Nishiyama O, Sano A Higashimoto Y, Tomita K, Tohda Y. Characteristics of phenotypes of elderly patients with asthma. Allergol Int 2016;65(2):204-9.

  25. Barua P, O’Mahony MS. Overcoming gaps in the management of asthma in older patients: new insights. Drugs Aging 2005; 22:1029-59.

  26. Stupka E: deShazo R. Asthma in seniors: Part 1. Evidence for underdiagnosis, undertreatment, and increasing morbidity and mortality. Am J Med 2009;122:6-11.

  27. Ilmarinen P, Tuomisto LE, Niemelä O, Danielsson J, Haanpää J, Kankaanranta T, Kankaanranta H. Comorbidities and elevated IL-6 associate with negative outcome in adult-onset asthma Eur Respir J 2016 ERJ-02198-2015.

  28. Jones SC, Iverson D, Burns P, Evers U, Caputi P, Morgan S. Asthma and ageing: an end user’s perspective–the perception and problems with the management of asthma in the elderly. Clin Exp Allergy 2011, 41:471-81.

  29. Nejjari C, Tessier JF, Barberger-Gateau P, Jacqmin H, Dartigues JF, Salamon R. Functional status of elderly people treated for asthma-related symptoms: a population based case-control study. Eur Respir J 1994;7(6):1077-83.

  30. Choi GS, Shin YS, Kim JH, Choi SY, Lee SK, Nam YH, Lee YM, Park HS. Premier Researchers Aiming New Era in Asthma and Allergic Disease (PRANA) Study Group. Prevalence and risk factors for depression in Korean adult patients with asthma: is there a difference between elderly and non-elderly patients? J Korean Med Sci. 2014, 29(12):1626-31

  31. Gomieiro LT, Nascimento A, Tanno LK, Agondi R, Kalil J, Giavina-Bianchi P. Respiratory exercise program for elderly individuals with asthma. Clinics (Sao Paulo) 2011, 66:1163-9.

  32. Ledford DK, Lockey RF. Asthma and comorbidities. Curr Opin Allergy Clin Immunol 2013;13:78-86.

  33. Boulet LP, Boulay ME: Asthma-related comorbidities. Expert Rev Respir Med 2011;5:377-93.

  34. Velazquez JR, Teran LM: Aspirin-intolerant asthma: a comprehensive review of biomarkers and pathophysiology. Clin Rev Allergy Immunol 2013, 45:75–86.

  35. Dunn TL, Gerber MJ, Shen AS, Fernandez E, Iseman MD, Cherniack RM: Theeffect of topical ophthalmic instillation of timolol and betaxolol on lung function in asthmatic subjects. Am Rev Respir Dis 1986, 133:264–268.

  36. Walsh LJ, Wong CA, Oborne J, Cooper S, Lewis SA, Pringle M, et al. Adverse effects of oral corticosteroids in relation to dose in patients with lung disease. Thorax 2001, 56:279–284.

  37. O’Byrne PM1, Pedersen S, Carlsson LG, Radner F, Thorén A, Peterson S, Ernst P, Suissa S. Risks of pneumonia in patients with asthma taking inhaled corticosteroids.Am J Respir Crit Care Med. 2011 183(5):589-95.

  38. Kennedy WA, Laurier C, Gautrin D, Ghezzo H, Paré M, Malo JL, Contandriopoulos AP. Occurrence and risk factors of oral candidiasis treated with oral antifungals in seniors using inhaled steroids. J Clin Epidemiol. 2000 53(7):696-701

  39. Korenblat PE, Kemp JP, Scherger JE, Minkwitz MC, Mezzanotte W. Effect of age on response to zafirlukast in patients with asthma in the Accolate Clinical Experience and Pharmacoepidemiology Trial (ACCEPT). Ann Allergy Asthma Immunol 2000, 84:217-25.

  40. Creticos P, Knobil K, Edwards LD, Rickard KA, Dorinsky P: Loss of response to treatment with leukotriene receptor antagonists but not inhaled corticosteroids in patients over 50 years of age. Ann Allergy Asthma Immunol 2002, 88:401-9.

  41. Gupta P, O’Mahony MS: Potential adverse effects of bronchodilators in the treatment of airways obstruction in older people: recommendations for prescribing. Drugs Aging 2008, 25:415-43.

  42. Guyer AC, Long AA: Long-acting anticholinergics in the treatment of asthma. Curr Opin Allergy Clin Immunol 2013, 13:392-8.

  43. Lavorini F, Magnan A, Dubus JC, Voshaar T, Corbetta L, Broeders M, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med 2008, 102:593-604.

  44. Allen SC, Jain M, Ragab S, Malik N. Acquisition and short-term retention of inhaler techniques require intact executive function in elderly subjects. Age Ageing 2003, 32:299-302.

  45. Emtner M, Hedin A, Stalenheim G. Asthmatic patients’ views of a comprehensive asthma rehabilitation programme: a three-year follow-up. Physiother Res Int 1998, 3:175-93.

  46. Emtner M, Finne M, Stalenheim G. A 3-year follow-up of asthmatic patients participating in a 10-week rehabilitation program with emphasis on physical training. Arch Phys Med Rehabil. 1998, 79:539-44.

Autores

Anahí Yáñez
Centro de Investigaciones en Alergia y Enfermedades Respiratorias InAER. CABA, Rep. Argentina.
Carlos Bueno
Laboratorio de Virología, Departamento de Química Biológica, IQUIBICEN. Facultad de Ciencias Exactas y Naturales Universidad de Buenos Aires. CABA, Rep. Argentina.

Autor correspondencia

Anahí Yáñez
Centro de Investigaciones en Alergia y Enfermedades Respiratorias InAER. CABA, Rep. Argentina.

Correo electrónico: ar­chi­vo­s@a­ler­gia.or­g.ar

Para descargar el PDF del artículo
Asma en adultos mayores

Haga click aquí


Para descargar el PDF de la revista completa
Revista Fronteras en Medicina, Volumen Año 2016 Num 4

Haga click aquí

 

Esta revista es una publicación de

Hospital Británico de Buenos Aires

Ir al sitio de la Sociedad

Este articulo pertenece a la revista

Revista Fronteras en Medicina

Ir al sitio de la revista

Revista Fronteras en Medicina
Número 4 | Volumen 11 | Año 2016

Titulo
Asma en adultos mayores

Autores
Anahí Yáñez, Carlos Bueno

Publicación
Revista Fronteras en Medicina

Editor
Hospital Británico de Buenos Aires

Fecha de publicación
2016-12-30

Registro de propiedad intelectual
© Hospital Británico de Buenos Aires

Reciba la revista gratis en su correo


Suscribase gratis a nuestra revista y recibala en su correo antes de su publicacion impresa.


Asociaciones que publican con nosotros:

Meducatium repositorio de informacion cientifica
Piedras 1333 2° C (C1240ABC) Ciudad Autónoma de Buenos Aires | Argentina | Argentina | tel./fax +54 11 5217-0292 | e-mail info@meducatium.com.ar | www.meducatium.com.ar

© Publicaciones Latinoamericanas S.R.L.

La plataforma Meducatium es un proyecto editorial de Publicaciones Latinoamericanas S.R.L.
Piedras 1333 2° C (C1240ABC) Ciudad Autónoma de Buenos Aires | Argentina | tel./fax (5411) 4362-1600 | e-mail info@publat.com.ar | www.publat.com.ar

Meducatium versión repositorio 1.0.1.0.9 beta