Professor Monroe J. King

Clinical Associate Professor Monroe J. King, D.O., University of South Florida College of Medicine

Reed: It's really quite unusual for someone over the age of 40 to develop an allergy to something unless it's something that they haven't been exposed to before. Yet, people still develop asthma in later middle age and beyond, even though they're not getting allergies. This is called "intrinsic asthma" as contrasted to "allergic asthma."

The cause of intrinsic asthma has not been established. The pathology and physiology is similar to allergic asthma, but the environment exposures and molecular processes that lead to airway inflammation have not been identified.

Q Is getting an asthma diagnosis hard for older adults?

King: This condition is under-diagnosed, and patients don't think of asthma as a disease older people can get. So, frequently older people attribute difficulty with breathing to aging. They just decrease their level of activity to accommodate it.

Q What would you advise an elderly person who's having problems breathing?

King: Have a pulmonary function test. And if your primary doctor can't do one, get referred to a pulmonologist or an allergist who can.

Seniors and asthma

Prevalence: Six percent to 10 percent of seniors may have asthma — a chronic inflammatory condition that affects airways in the lungs.

Symptoms: Coughing, chest tightness, shortness of breath, wheezing.

Diagnosis: Can be difficult, as asthma can co-exist with conditions that have similar symptoms, including chronic bronchitis, congestive heart failure, sinusitis, gastrointestinal reflux and chronic obstructive pulmonary disease.

Concerns: Drugs used to treat asthma can exacerbate osteoporosis. Drugs used to treat other conditions — beta-blockers, ACE inhibitors, aspirin, non-steroidal anti- inflammatory medications — can trigger or worsen asthma.

Treatment: Eliminate environmental triggers such as dust mites or mold. Use medications to reduce inflammation and open inflamed airways.

SOURCE: American Academy of Allergy, Asthma & Immunology