Tessier J F, Nejjari C, Barberger-Gateau P, Dartigues J F
INSERM U330, Université de Bordeaux II.
Rev Mal Respir. 1993;10(5):423-31.
Increased longevity and the maintenance of autonomy in the elderly has lead to an enlargement of the study of asthma beyond 65 years. If the majority of published work in the literature concludes there is an excess mortality in the elderly asthmatic one cannot exclude the possibility that this excess mortality is due to the association, at this age, of asthma with other respiratory problems. This association would also explain the great variations in prevalence reported by different authors, from 3 to 6% with notable differences according to the sex. Bronchial reactivity appears to be less linked to allergy after 65 than in the young subject. In the elderly asthmatic the frequency of a past history of allergy and of positive cutaneous tests are weaker than in the young, and there is little difference when compared to the non-asthmatic subject. On the other hand the majority of studies show that smoking, respiratory infections, and social class are particularly linked to asthma beyond the age of 65. Although the data on predictive factors may be rare and contradictory certain published works suggest that deterioration in respiratory function most often precedes the appearance of symptoms suggesting the diagnosis. Many uncertainties remain in relation to asthma in the elderly. This is because in large part there are insufficiently specific identifying criteria. There is a need to develop standardised methods of evaluating respiratory handicap, notably specific data on the quality of life as this would be indispensable in evaluating the consequence of asthma in the elderly subject.
老年人寿命的延长和自主性的维持使得哮喘的研究范围扩大到了65岁以上。如果文献中大多数已发表的研究得出结论，老年哮喘患者存在额外的死亡率，那么就不能排除这种额外死亡率是由于在这个年龄段哮喘与其他呼吸问题相关联所致的可能性。这种关联也可以解释不同作者报告的患病率差异很大，从3%到6%，且根据性别有显著差异。65岁以后，支气管反应性似乎比年轻受试者更少与过敏相关。在老年哮喘患者中，过敏既往史和皮肤试验阳性的频率比年轻人低，与非哮喘患者相比差异不大。另一方面，大多数研究表明，吸烟、呼吸道感染和社会阶层与65岁以上的哮喘尤其相关。尽管关于预测因素的数据可能很少且相互矛盾，但某些已发表的研究表明，呼吸功能恶化最常先于提示诊断的症状出现。关于老年哮喘仍存在许多不确定性。这在很大程度上是因为缺乏足够具体的识别标准。需要开发标准化的评估呼吸障碍的方法，特别是关于生活质量的具体数据，因为这在评估老年哮喘患者的后果时将是必不可少的。
