Oraka Emeka, Kim Huyi Jin Elizabeth, King Michael E, Callahan David B
Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30324, USA.
J Asthma. 2012 Aug;49(6):593-9. doi: 10.3109/02770903.2012.684252. Epub 2012 Jul 6.
For over three decades, the greatest burden of asthma deaths has occurred among persons aged 65 years and older. This study analyzed the association between increasing age and asthma prevalence among age groups within the US elderly population.
We analyzed aggregated data on 54,485 civilian, noninstitutionalized US adults aged 65 years and older from the 2001-2010 National Health Interview Survey (NHIS). We estimated the prevalence of current asthma, lifetime asthma, and chronic obstructive pulmonary disease (COPD) among US elderly by 5-year age groups and age stages ("young elderly" aged 65-84 years and "oldest old" aged ≥85 years). We calculated adjusted odds ratios (AOR) and 95% confidence intervals (CI) to identify asthma prevalence patterns among elderly populations.
From 2001 to 2010, the estimated average annual prevalence of current asthma among US elderly was 7.0%. Estimates of lifetime asthma, COPD, and co-occurring current asthma and COPD were 9.9%, 9.7%, and 3.0%, respectively. Prevalence of asthma decreased with advancing age while prevalence of COPD increased with advancing age. When controlling for study variables and significant interactions (p = .05) with COPD, the odds of reporting current asthma decreased with advancing age: 0.87 (95% CI, 0.76-1.01) for 70- to 74-year-olds; 0.76 (95% CI, 0.66-0.87) for 75- to 79-year-olds; 0.62 (95% CI, 0.51-0.75) for 80- to 84-year-olds; and 0.45 (95% CI, 0.36-0.55) for ≥85-year-olds, as compared to 65- to 69-year-olds.
Asthma continues to affect a substantial proportion of the US elderly population. Increased diagnosis of COPD may overshadow correct diagnosis and treatment in populations with advancing age. Treatment guidelines should focus on preventable risk behaviors to increase the quality of life within this population.
三十多年来，哮喘死亡的最大负担发生在65岁及以上人群中。本研究分析了美国老年人群中年龄增长与哮喘患病率之间的关联。
我们分析了来自2001 - 2010年美国国家健康访谈调查（NHIS）的54485名65岁及以上美国非机构化平民成年人的汇总数据。我们按5岁年龄组和年龄阶段（65 - 84岁的“年轻老年人”和≥85岁的“最年长者”）估算了美国老年人中当前哮喘、终生哮喘和慢性阻塞性肺疾病（COPD）的患病率。我们计算了调整后的优势比（AOR）和95%置信区间（CI），以确定老年人群中的哮喘患病率模式。
2001年至2010年，美国老年人中当前哮喘的估计年均患病率为7.0%。终生哮喘、COPD以及同时患有当前哮喘和COPD的估计患病率分别为9.9%、9.7%和3.0%。哮喘患病率随年龄增长而下降，而COPD患病率随年龄增长而上升。在控制研究变量以及与COPD的显著交互作用（p = 0.05）后，报告当前哮喘的几率随年龄增长而降低：70至74岁人群为0.87（95% CI，0.76 - 1.01）；75至79岁人群为0.76（95% CI，0.66 - 0.87）；80至84岁人群为0.62（95% CI，0.51 - 0.75）；≥85岁人群为0.45（95% CI，0.36 - 0.55），与65至69岁人群相比。
哮喘继续影响着相当比例的美国老年人群。COPD诊断增加可能掩盖了老年人群中正确的诊断和治疗。治疗指南应侧重于可预防的风险行为，以提高该人群的生活质量。
