Elderly asthmatics medically misdiagnosed

A research paper published in this month’s issue of Australian Family Physician raises concerns about the level of misdiagnosis and treatment of asthma in the elderly.

Co-author Professor Christine Jenkins, leading respiratory physician and head of Woolcock Institute Asthma Research in Sydney, said Australians aged over 65 tend to attribute breathlessness to old age, a lack of fitness or other health problems, rather than asthma. This is despite most asthma related deaths occurring in this age group.

The paper also indicates a tendency by sufferers to understate the seriousness of symptoms which, combined with a failing by physicians to accurately diagnose the disease in the elderly, can impact negatively on their quality of life.

Prof Jenkins said the paper highlighted the need to improve the management of asthma among the elderly and address the specific needs of this group with tailored educational programs and appropriate care.

"Impaired perception of asthma severity, poor medication adherence, physical disability, cognitive dysfunction and a passive self-management approach, all contribute to poor asthma outcomes among the elderly," she said.

Prof Jenkins added that in Australia, children under four years of age and those 65 years and over are most likely to be hospitalised after an asthma related emergency department visit and require the longest hospital stays.

"Difficulties do occur when differentiating asthma from other diseases causing breathlessness in older people," she said, "but as health professionals we need to find new ways to assess the impact of asthma symptoms in older patients.

"More work needs to be put into meeting the particular needs of the elderly in order to provide appropriate asthma care and achieve optimal health outcomes."