Listen to Maria Sanchez, a 71-year-old Sweetwater resident, describe an asthma attack: “You can’t breathe. You gasp. Your chest feels tight. It’s horrible.”
Those symptoms are chillingly familiar for the 25 million Americans with asthma, an inflammatory disease of the breathing passages of the lungs, but they also are particularly dangerous for older sufferers who are more likely to die as a result of the illness than their younger counterparts. In fact, asthma poses more medical hazards for seniors than it does for children and teens, though asthma is the most common chronic condition among children.
A University of Cincinnati study recently published in Annals of Allergy, Asthma & Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), revealed that the death rate among the 65-and-over set is 14 times higher than in patients 18 to 35 years old.
Why? Theories abound. Older patients tend to have other medical conditions that can exacerbate asthma symptoms. They also are more likely to develop respiratory failure. And seniors with mild asthma attacks had the same level of breathing trouble as younger patients with severe attacks.
“Older people tend to have a lot of other medical problems,” says Dr. Timothy Scialla, assistant professor in the pulmonary medicine and critical care department in the Miller School of Medicine at the University of Miami. “They have a lot of things going on and as a result there can be an overreaction to an attack.”
Asthma in seniors is of particular concern because experts believe the number of asthmatics 65 and older — 3.1 million now — will double in the next 25 years as the baby boomer generation, more than 78 million strong, slides into old age.
And while asthma is a disease that can be managed with proper medication and regular visits to the doctor, an alarming percentage of older asthmatics are letting their disease go untreated. Only 53 percent of asthmatic baby boomers use prescribed inhalers, a figure that worries the medical community — with good reason. Older people account for 60 percent of the annual 4,000 deaths due to asthma and death rates have increased more than 50 percent since 1980.
Also, some medications taken for other chronic conditions — for example, beta blockers for hypertension — can also worsen asthmatic conditions.
In some cases, older patients never bother checking out the reason for their wheezing and shortness of breath. “They don’t think they have asthma,” says allergist Dr. Viviana Sirven, a representative of ACAAI in West Kendall. “They think it’s a pulmonary problem of some other kind or a result of another condition.”
Some are also misdiagnosed, because other ailments — heart disease and emphysema, for example — may mask the asthma. “I hear all the time from patients that they hadn’t been told [by their doctors] that they had asthma. They say, ‘The doctor told me my lungs are not what they used to be,’ ” said Dr. Jorge Camilo Mora, assistant professor in the division of family medicine at Florida International University.
But even with an accurate diagnosis, some asthmatics end up undertreated. “They begin to feel better, they don’t feel tight, so they stop taking medication,” says Sirven. “Or if they’re taking lots of medications, and many older people are, they prioritize which medicines they can afford.”
Older patients are also more sensitive to asthma medications, FIU’s Mora says, and may shy away from side effects. Some may have memory problems, finding it harder to follow treatment instructions. Others, with arthritis, have difficulty pressing down on an inhaler, while drawing a short, deep breath.
Sanchez, a patient of Sirven’s, developed asthma about six years ago after a lifelong battle with allergies. On medication, she had not suffered an attack for many months until a bad flu recently landed her in the emergency room when it aggravated her asthma.
“I can’t say it enough,” she adds. “It’s important to get your breathing problems checked out... With medication, you can lead a pretty normal life.”