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Abstract
At least 2 million US citizens over 65 years of age have asthma as a chronic disease,
a number that will rapidly increase as the population ages. We used computer-assisted
searches to identify epidemiologic studies specific for this age group published in
the commonly available medical literature in English between 1988 and 2008. The prevalence
of current asthma in individuals aged over 65 years is high (5.3%). Affected patients
appear to perceive symptoms of asthma differently than younger patients, often have
comorbid conditions with similar symptoms, and present for medical care later and
with more fixed airways obstruction. Approximately 50% of deaths from asthma occur
in the elderly, and mortality is increasing (10.5/100,000). We found only one longitudinal
epidemiologic study that addressed the natural history of asthma in patients aged
over 65 years, and that study used historical controls. Asthma in the elderly is a
poorly studied, growing chronic disease that is underdiagnosed and undertreated. Present
paradigms for diagnosis require modification.