Older asthmatic patients have increased discrepancies between symptoms and objective asthma control parameters

• Published in: Canadian journal of respiratory, critical care, and sleep medicine critical care, and sleep medicine, 2020-01, Vol.4 (1), p.7-13
• Main Authors: Grégoire, Julie, Boulay, Marie-Eve, Robitaille, Catherine, Bertrand, Mylène, Villeneuve, Hélène, Deschesnes, Francine, Boulet, Louis-Philippe
• Format: Article
• Language: English
• Subjects: aging; Asthma; asthma control; inflammation; symptoms
• ISSN: 2474-5332; 2474-5340
• DOI: 10.1080/24745332.2019.1573650

RATIONALE: Discrepancies between clinical, physiological and inflammatory asthma control parameters need to be documented in older patients. OBJECTIVE: To compare the prevalence of discrepancies between asthma control parameters among older and younger patients. METHODS: This retrospective, cross-sectional study compared data from older (≥60 years; n = 92) and younger (18-35 years; n = 266) subjects with asthma. Discrepancies ( > 20% difference) between any two parameters of the asthma control scoring system (ACSS): (1) clinical (respiratory symptoms), (2) physiological (forced expiratory volume in one second percent predicted) and (3) inflammatory (sputum eosinophil percentage) were determined. MEASUREMENTS AND MAIN RESULTS: Fifty-seven percent of older asthmatics had at least one discrepancy, against 40% of younger (P = 0.008). A higher proportion of older patients showed discrepancies between clinical and physiological scores (P = 0.0005) and between clinical and inflammatory scores (P = 0.007), with a better clinical than physiological or inflammatory score in most cases. CONCLUSION: The increased prevalence of discrepancies between asthma control parameters in older asthmatics strengthens the importance of considering all parameters of control in the evaluation and management of asthma in older patients.