oa Current Allergy & Clinical Immunology - Asthma, allergic rhinitis and atopic eczema in the elderly : review articles

Volume 21 Number 3
  • ISSN : 1609-3607



This article briefly reviews the anatomical, physiological and immunological changes which occur with age in relation to the presentation, diagnosis and management of asthma, rhinitis and eczema in the elderly. Although new onset of asthma is much less common in the elderly, the prevalence is up to 17%. Because the classic symptoms of asthma have a poor predictive value in the elderly and breathlessness is underestimated by the patient due to a combination of altered sensory perception and multiple pathologies leading to reduced function and activity, the diagnosis is often missed. Because of physiological and immunological changes with age there is an increase in lower respiratory tract infections and chronic bronchitis, or aspiration often coexists with bronchospasm. In addition changes in respiratory physiology make the interpretation of pulmonary function tests difficult and the differential diagnosis is wide. In the elderly management is not only complicated by a higher incidence of adverse drug effects but the problems of multiple pathologies, polypharmacy and drug-drug interactions. The article explores the efficacy and problems associated with medications used to manage asthma in the elderly. Similarly it is unusual for a new diagnosis of allergic rhinitis or eczema to be made in the elderly and the clinician should focus on the wide spectrum of possible pathologies which form the differential diagnosis of these conditions. The article discusses the investigation and diagnosis of rhinitis and eczema in the elderly and highlights the potential problems of therapy and which drugs are preferred.

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