Centre for Health Initiatives, University of Wollongong, Wollongong, NSW, Australia.
Clin Exp Allergy. 2011 Apr;41(4):471-81. doi: 10.1111/j.1365-2222.2011.03718.x.
Despite the high prevalence of asthma in the elderly, its development, diagnosis, and treatment are under-researched. This paper provides a comprehensive review of the current state of knowledge in relation to management of asthma in the elderly - focusing on barriers to diagnosis and treatment and the central role of self-management. Asthma prevalence increases with age, as does the risk of dying from asthma, and with the ageing of the population and increasing life expectancy, the prevalence of (diagnosed and undiagnosed) asthma in older adults is expected to increase drastically, placing an increasing burden on sufferers, the community and health budgets. Asthma sufferers are more likely to be psychologically distressed and at a higher risk of anxiety and depression, more likely to experience a sense of lack of control over their health and to have lower self-reported quality of life. Asthma is under-diagnosed, and under-treated, in the elderly, further exacerbating these negative consequences. The review concludes, among other things, that there is a need to better understand the development and impact of asthma in the elderly, to increase community awareness of asthma in the elderly, to improve both 'medical management' and 'self-management' in this population and to develop more effective tools for diagnosis and treatment of asthma in the elderly. The paper concludes with key recommendations for future research and practice in this area.
尽管老年人哮喘的患病率很高，但对其发病机制、诊断和治疗的研究还很不足。本文全面回顾了老年人哮喘管理方面的现有知识状况，重点讨论了诊断和治疗方面的障碍，以及自我管理的核心作用。哮喘的患病率随年龄增长而增加，死于哮喘的风险也随之增加。随着人口老龄化和预期寿命的延长，（确诊和未确诊的）老年哮喘的患病率预计将大幅上升，这将给患者、社区和医疗预算带来越来越大的负担。哮喘患者更有可能出现心理困扰，焦虑和抑郁的风险更高，更有可能感到对自己的健康缺乏控制，报告的生活质量也更低。老年人哮喘的诊断不足，治疗不足，进一步加剧了这些负面影响。本文除其他外得出结论，需要更好地了解老年人哮喘的发病机制和影响，提高社区对老年人哮喘的认识，改善这一人群的“医疗管理”和“自我管理”，并开发更有效的老年人哮喘诊断和治疗工具。本文最后提出了该领域未来研究和实践的关键建议。
