Shinke Haruko, Kamiryo Hiroshi, Umezawa Kanoko, Hori Suya, Nakata Kyosuke, Nagano Tatsuya, Hazeki Nobuko, Kobayashi Kazuyuki, Fukabori Takashi, Nishimura Yoshihiro
Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Fukabori Clinic, Kobe, Japan.
Kobe J Med Sci. 2019 Feb 13;64(5):E174-E179.
In developed countries such as North America, the decline in mortality from bronchial asthma has ceased since 2006. The decline in mortality rate is also decreasing in Japan, where about 1,500 asthma deaths have been reported. Among these, elderly people aged 65 years or over account for about 90% of cases. Therefore, the treatment of elderly patients with asthma is an important subject. However, few studies have been conducted on asthma in elderly patients. In this survey, we distributed a questionnaire to 253 elderly care facilities in Kobe, Japan. Ninety facilities responded, and 223 patients in 70 out of 90 facilities were diagnosed with asthma. Dry powder inhaler was the most commonly used dosage form of inhaled corticosteroids. Many facilities have patients who need some assistance during inhalation: only 60% of facilities reported that inhalation is performed accurately. While 31 facilities had patients with a history of hospitalization for asthma attacks, only 14 of these facilities were able to provide appropriate initial treatment. Many facilities have difficulty providing assistance with inhalation to elderly patients whose cognitive function has deteriorated. This survey highlights challenges experienced by care facilities in treating asthma in the elderly.
在北美等发达国家，自2006年以来，支气管哮喘死亡率的下降趋势已经停止。在日本，死亡率的下降速度也在减缓，据报道日本约有1500例哮喘死亡病例。其中，65岁及以上的老年人约占90%。因此，老年哮喘患者的治疗是一个重要课题。然而，针对老年哮喘患者的研究很少。在本次调查中，我们向日本神户的253家老年护理机构发放了问卷。90家机构做出了回应，90家机构中的70家有223名患者被诊断为哮喘。干粉吸入器是吸入性糖皮质激素最常用的剂型。许多机构的患者在吸入过程中需要一些帮助：只有60%的机构报告吸入操作准确。虽然有31家机构的患者有哮喘发作住院史，但其中只有14家机构能够提供适当的初始治疗。许多机构在为认知功能已经衰退的老年患者提供吸入帮助方面存在困难。本次调查凸显了护理机构在治疗老年哮喘患者时遇到的挑战。
