Asthma in later life
Some people who have had asthma all their life may find that it starts affecting them in different ways when they get older. For example, they may have coughed or wheezed previously, but as they get older, they may notice they become more breathless.
Changing triggers
For older people, the symptoms of asthma are less likely to be triggered by allergies such as house-dust mites, furry and feathered pets and pollen. Instead, their asthma symptoms may well be triggered by factors such as;
- Flu, cold, or other viral infections
- Exercise, depression or anxiety
- Wet and damp conditions, which may encourage the growth of certain moulds that can trigger an attack.
- Certain medications can trigger a worsening of asthma symptoms (see "Asthma and other medications" section below)
- Exposure to irritants such as cigarette smoke, cold air, perfumes and chemical fumes.
If you are over 65 years of age then you should have the annual flu vaccination and consider a regular pneumonia vaccination. Both vaccinations should be available from your local surgery.
Developing asthma in later life
If you have experienced symptoms such as wheezing, coughing or shortness of breath, but have never been diagnosed with asthma or any other lung condition then arrange to see your GP or practice nurse.
If you have any of the asthma symptoms mentioned above, or have a history of smoking, and have a few moments to spare, you might want to fill in our self-assessment questionnaire. The questionnaire will take a few minutes to complete, and will give you an instant indication of whether you are likely to have developed asthma. It also offers a customised feedback and advice on your individual lifestyle.
However, if you are experiencing symptoms that you think could be the result of asthma, the questionnaire should be completed in addition, NOT IN PLACE, of seeing your GP.
Is breathlessness normal?
Many older patients regard breathlessness and cough as simply "signs of old age" and can be reluctant to "bother" their GP. Although age is associated with a gradual decrease in lung function, our respiratory systems are designed to allow us to breath adequately throughout our lives. Any symptoms of breathlessness and asthma should be investigated, whatever your age.
Symptoms typical of asthma, such as intermittent wheezing, breathlessness, and cough, are shared with a number of other respiratory problems in older patients, particularly chronic obstructive pulmonary disease (COPD). Similarly, other symptoms of asthma such as chest pain or tightness may be due to other chest problems such as heart disease, pnuemonia, or pulmonary embolism.
If you have not been diagnosed with asthma or any other lung condition and are experiencing breathlessness then you should arrange to see your doctor to discuss your symptoms.
Living with asthma as you get older
Due to other health problems, many older people are not able to exercise. The chronic pain from other conditions, such as arthritis, can put a strain on the body increasing the likelihood of asthma attacks. Try increasing activity throughout the week by doing gentle walking for 30 minutes. Swimming is an excellent alternative for people with joint pain.
The lungs ability to function efficiently also declines slowly with age and the effects of this can be made worse by conditions such as age-related osteoporosis that make the chest wall stiffer.
Poor nutrition can also reduce muscle strength in the chest, which can reduce the amount of oxygen taken in one full breath. Try to make sure you eat a well-balanced diet; ask your GP or Practice nurse for dietary advice and / or a meal diary to help record what you are eating.
Sensitivity to certain medications
People with asthma can be sensitive to some other types medications, some of which can cause asthma symptoms to flare up.
Pain relief
Aspirin and other types of pain killers have been associated with worsening asthma symptoms in some patients. Other pain killers that can have this effect are those often used to treat arthritis such as non-steroidal anti-inflammatory drugs (NSAIDS), including ibuprofen and naproxen. Asthma attacks caused by any of these medications can be severe, so these drugs must be completely avoided in people who have known "aspirin-sensitive" asthma.
It is important that people with aspirin sensitivity read labels of medications used to treat pain, colds, coughs and fever. Also inform your doctor so that these medications are not prescribed for you. Products with paracetamol are considered safe for people who have asthma.
If you have any questions whether a certain medication could trigger your asthma, seek advice from your health care provider.
Beta-blockers
Beta-blockers are commonly prescribed medications used to treat numerous conditions, including: heart conditions; high blood pressure; migraine headache, and (in eye drop form) glaucoma.
If you have asthma, you should never take beta-blockers in tablet form. Make sure you tell all your healthcare providers who may need to prescribe these types of medications that you have asthma, even your eye doctor.
Please speak to your GP/Practice nurse if you have any concerns about any current medication.
ACE inhibitors
ACE inhibitions are one of a number of types of medications used to treat heart disease and high blood pressure. Evidence has shown that they can cause coughs in about 10% of the patients who use them. Although this cough is not necessarily asthma, it can be confused with asthma or, in the case of unstable airways, can actually trigger wheeze and chest tightness. Contact your doctor if you are prescribed an ACE inhibitor and develop a cough.
Examples of commonly prescribed ACE inhibitors include: Captopril, Lotensin, Rampril, Monopril, Prinivil, Trandolapril, Enalapril and Zestril.
Cold and infections
If you are unfortunate enough to catch a cold or develop a chest infection, it is particularly important to look after yourself well. This involves taking your medication daily as advised by your GP or Practice Nurse and following the self-management plan that you will have discussed during your asthma reviews.
Safety of operations
It is safe to have an operation as long as your asthma is well controlled. If you are awaiting an operation, speak to your GP or Practice Nurse about your current asthma control. By looking at your previous history and current symptoms they can give any advice you may need ahead of your operation.
You should always inform the hospital consultant if you have asthma and if you have had any exacerbations in the last 2-3 years that has resulted in you taking oral steroids to control it.
If you have a few moments to spare, you might want to fill in our self-assessment questionnaire to give you an indication of how well controlled your asthma currently is. The questionnaire will only take a few minutes to complete. You will get an instant customised feedback based on your answers and also advice on individual lifestyle.