Asthma is Not Just Kids’ Stuff

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On World Asthma Day, experts warn disease can occur at any age; adults face special challenges

Doug Cooper was surprised when his doctor told him he had asthma, not because he’d had no symptoms – his breathing had been troubling him for a while. He just wasn’t expecting an asthma diagnosis at the age of 50.

“I’d always assumed that asthma was a disease that started in childhood,” said the retired aircraft engine technician. “I learned that asthma can develop at any age.”

One in 10 Ontarians over the age of 40 has asthma. Many of them have lived with the illness since childhood. Sometimes, asthma that went away after childhood reappears later in life. But asthma can also occur in adults and seniors with no history of respiratory problems. Elderly people accounted for three-quarters of the 218 asthma deaths in Canada in 2011.

“Older people often dismiss symptoms as a normal part of aging,” said Dr. Anna Day, respirologist at Women’s College Hospital in Toronto, and spokesperson for the Ontario Lung Association. “As a result they might not realize they have asthma until the disease becomes moderate or severe.”

Symptoms of asthma include coughing, wheezing, airway tightness, shortness of breath and mucus production. These symptoms can be aggravated by colds and viruses, allergens, air pollution, strong smells, cold weather, humidity, exercise and stress.

Dr. Day said that early, accurate diagnosis is vital. “Once asthma is confirmed, there are effective management strategies to keep it under control. Well-controlled asthma should not limit your life and you should be able to exercise and sleep normally. With well-controlled asthma you are less likely to have a potentially dangerous asthma attack or risk permanent damage to your lungs.”

Diagnosis starts with the health-care provider, who will conduct a physical examination and ask questions about family history, symptoms and other related conditions. Next comes a simple breathing test called spirometry during which the patient blows into a machine that measures air flow and volume.

“Patients with adult-onset asthma face special challenges,” said Carole Madeley, director of respiratory programs with the Ontario Lung Association. “They often experience a more rapid decline in lung function and more severe and persistent airflow limitation.”

Mould exposure at home and at work is an important cause of asthma later in life. Exposure to other workplace triggers is another common cause of adult-onset asthma. There are more than 300 substances known to cause occupational asthma, including wood dust at sawmills, chemical fumes in the plastics industry or flour in a bakery.

Adult-onset asthma can also become a problem with prescribed as well as over-the-counter medications. These include non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen or aspirin and beta-blockers for hypertension or glaucoma (e.g., Propranolol).

Asthma in adults and seniors can be triggered by everyday allergens – mould, dust mites, pet dander, pollen, etc. – as well as exposure to tobacco or marijuana smoke.

Asthma symptoms in older patients are often masked by – or even caused by – other diseases that have similar symptoms. The most common are chronic obstructive pulmonary disease (COPD) and cardiac conditions such as congestive heart failure and arrhythmias. Other diseases that mimic asthma include pulmonary fibrosis, pulmonary embolism, lung cancer, obesity, sinusitis and gastro-esophageal reflux disease.

John Chenery

416-864-9911 ext. 292 | Cell: 647-293-9911 | jchenery@on.lung.ca

The Ontario Lung Association is a registered charity that provides information, education and funding for research to improve lung health. The organization focuses on the prevention and control of asthma and chronic lung disease, tobacco control and clean air. The Lung Health Information Line – 1‐888‐344‐LUNG (5864) – is staffed by certified respiratory educators.

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