Asthma: a six-part strategy for managing older patients.

Asthma is a common, serious disease among older adults but one that is often misdiagnosed and mistreated. Recently-published management strategies by consensus groups are effective and, with some modifications, applicable to the treatment of older adults. Conditions to consider in the differential diagnosis are COPD, bronchiectasis, and congestive heart failure, all of which may be indistinguishable from asthma by history. Thus, all patients with suspected asthma require pulmonary function tests. Treatment is a six-part strategy consisting of education, objective measurement of lung function, environmental control, medication for chronic and acute asthma, and regular follow-up. Special considerations in older patients include measures to enhance compliance and attention to drug interactions and coexistent diseases.