Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop

Nicola A. Hanania; Monroe J. King; Sidney S. Braman; Carol Saltoun; Robert A. Wise; Paul Enright; Ann R. Falsey; Sameer K. Mathur; Joe W. Ramsdell; Linda Rogers; David A. Stempel; John J. Lima; James E. Fish; Sandra R. Wilson; Cynthia Boyd; Kushang V. Patel; Charles G. Irvin; Barbara P. Yawn; Ethan A. Halm; Stephen I. Wasserman; Mark F. Sands; William B. Ershler; Dennis K. Ledford

doi:10.1016/j.jaci.2011.06.048

Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop

Nicola A. Hanania, Monroe J. King^*, Sidney S. Braman, Carol Saltoun, Robert A. Wise, Paul Enright, Ann R. Falsey, Sameer K. Mathur, Joe W. Ramsdell, Linda Rogers, David A. Stempel, John J. Lima, James E. Fish, Sandra R. Wilson, Cynthia Boyd, Kushang V. Patel, Charles G. Irvin, Barbara P. Yawn, Ethan A. Halm, Stephen I. WassermanMark F. Sands, William B. Ershler, Dennis K. Ledford

^*Corresponding author for this work

Medicine, Allergy Division

Research output: Contribution to journal › Article › peer-review

199 Scopus citations

Abstract

Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.

Original language	English (US)
Pages (from-to)	S4-S24
Journal	Journal of Allergy and Clinical Immunology
Volume	128
Issue number	3 SUPPL.
DOIs	https://doi.org/10.1016/j.jaci.2011.06.048
State	Published - Sep 2011

Funding

Disclosure of potential conflict of interest: N. A. Hanania is on the speakers’ bureau for GlaxoSmithKline, AstraZeneca, and Genentech; is on advisory boards for GlaxoSmithKline, Genentech, Novartis, and Pfizer; and receives research support from GlaxoSmithKline , Genentech , Novartis , and Pfizer . M. J. King has consultant arrangements with the National Institutes of Health (NIH). R. A. Wise has consultant arrangements with AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Sunovion, and Merck and receives research support from GlaxoSmithKline , Boehringer Ingelheim , Forest , and Merck . A. R. Falsey has consultant arrangements with MedImmune and Sanofi Pasteur and receives research support from Sanofi Pasteur and GlaxoSmithKline . S. K. Mathur receives research support from the NIH and is vice-chair of the American Academy of Allergy, Asthma & Immunology (AAAAI)’s Asthma and Allergic Diseases in the Elderly committee. D. A. Stempel is employed by GlaxoSmithKline. J. J. Lima receives research support from the NIH and the American Lung Association . J. E. Fish is employed by Merck & Co, Inc. S. R. Wilson receives research support from the National Heart , Lung , and Blood Institute/NIH . C. G. Irvin is on the speakers’ bureau for Merck and the advisory board for MethaPharm, receives research support from the NIH and the American Lung Association , and is on the advisory board for the Vermont Department of Health. B. P. Yawn has consulted for the American Thoracic Society, receives research support from the Agency for Healthcare Research and Quality , and is the chair of the state coalition for asthma for the American Lung Association. S. I. Wasserman receives research support from the American Lung Association , has provided legal consultation or expert witness testimony in cases related to mold injury and medical malpractice, and is president of the American Board of Allergy and Immunology. The rest of the authors have declared that they have no conflict of interest. Publication of this article was supported by the National Institute on Aging .

Keywords

Aging
airway
allergy
asthma
elderly
immune mechanisms
immunosenescence

ASJC Scopus subject areas

Immunology and Allergy
Immunology

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10.1016/j.jaci.2011.06.048

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Hanania, N. A., King, M. J., Braman, S. S., Saltoun, C., Wise, R. A., Enright, P., Falsey, A. R., Mathur, S. K., Ramsdell, J. W., Rogers, L., Stempel, D. A., Lima, J. J., Fish, J. E., Wilson, S. R., Boyd, C., Patel, K. V., Irvin, C. G., Yawn, B. P., Halm, E. A., ... Ledford, D. K. (2011). Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop. Journal of Allergy and Clinical Immunology, 128(3 SUPPL.), S4-S24. https://doi.org/10.1016/j.jaci.2011.06.048

@article{79e971a7253a44b4a0af17a438b4a600,

title = "Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop",

abstract = "Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.",

keywords = "Aging, airway, allergy, asthma, elderly, immune mechanisms, immunosenescence",

author = "Hanania, {Nicola A.} and King, {Monroe J.} and Braman, {Sidney S.} and Carol Saltoun and Wise, {Robert A.} and Paul Enright and Falsey, {Ann R.} and Mathur, {Sameer K.} and Ramsdell, {Joe W.} and Linda Rogers and Stempel, {David A.} and Lima, {John J.} and Fish, {James E.} and Wilson, {Sandra R.} and Cynthia Boyd and Patel, {Kushang V.} and Irvin, {Charles G.} and Yawn, {Barbara P.} and Halm, {Ethan A.} and Wasserman, {Stephen I.} and Sands, {Mark F.} and Ershler, {William B.} and Ledford, {Dennis K.}",

note = "Funding Information: Disclosure of potential conflict of interest: N. A. Hanania is on the speakers{\textquoteright} bureau for GlaxoSmithKline, AstraZeneca, and Genentech; is on advisory boards for GlaxoSmithKline, Genentech, Novartis, and Pfizer; and receives research support from GlaxoSmithKline , Genentech , Novartis , and Pfizer . M. J. King has consultant arrangements with the National Institutes of Health (NIH). R. A. Wise has consultant arrangements with AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Sunovion, and Merck and receives research support from GlaxoSmithKline , Boehringer Ingelheim , Forest , and Merck . A. R. Falsey has consultant arrangements with MedImmune and Sanofi Pasteur and receives research support from Sanofi Pasteur and GlaxoSmithKline . S. K. Mathur receives research support from the NIH and is vice-chair of the American Academy of Allergy, Asthma & Immunology (AAAAI){\textquoteright}s Asthma and Allergic Diseases in the Elderly committee. D. A. Stempel is employed by GlaxoSmithKline. J. J. Lima receives research support from the NIH and the American Lung Association . J. E. Fish is employed by Merck & Co, Inc. S. R. Wilson receives research support from the National Heart , Lung , and Blood Institute/NIH . C. G. Irvin is on the speakers{\textquoteright} bureau for Merck and the advisory board for MethaPharm, receives research support from the NIH and the American Lung Association , and is on the advisory board for the Vermont Department of Health. B. P. Yawn has consulted for the American Thoracic Society, receives research support from the Agency for Healthcare Research and Quality , and is the chair of the state coalition for asthma for the American Lung Association. S. I. Wasserman receives research support from the American Lung Association , has provided legal consultation or expert witness testimony in cases related to mold injury and medical malpractice, and is president of the American Board of Allergy and Immunology. The rest of the authors have declared that they have no conflict of interest. Funding Information: Publication of this article was supported by the National Institute on Aging . ",

year = "2011",

month = sep,

doi = "10.1016/j.jaci.2011.06.048",

language = "English (US)",

volume = "128",

pages = "S4--S24",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Elsevier Inc.",

number = "3 SUPPL.",

}

Hanania, NA, King, MJ, Braman, SS, Saltoun, C, Wise, RA, Enright, P, Falsey, AR, Mathur, SK, Ramsdell, JW, Rogers, L, Stempel, DA, Lima, JJ, Fish, JE, Wilson, SR, Boyd, C, Patel, KV, Irvin, CG, Yawn, BP, Halm, EA, Wasserman, SI, Sands, MF, Ershler, WB & Ledford, DK 2011, 'Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop', Journal of Allergy and Clinical Immunology, vol. 128, no. 3 SUPPL., pp. S4-S24. https://doi.org/10.1016/j.jaci.2011.06.048

TY - JOUR

T1 - Asthma in the elderly

T2 - Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop

AU - Hanania, Nicola A.

AU - King, Monroe J.

AU - Braman, Sidney S.

AU - Saltoun, Carol

AU - Wise, Robert A.

AU - Enright, Paul

AU - Falsey, Ann R.

AU - Mathur, Sameer K.

AU - Ramsdell, Joe W.

AU - Rogers, Linda

AU - Stempel, David A.

AU - Lima, John J.

AU - Fish, James E.

AU - Wilson, Sandra R.

AU - Boyd, Cynthia

AU - Patel, Kushang V.

AU - Irvin, Charles G.

AU - Yawn, Barbara P.

AU - Halm, Ethan A.

AU - Wasserman, Stephen I.

AU - Sands, Mark F.

AU - Ershler, William B.

AU - Ledford, Dennis K.

N1 - Funding Information: Disclosure of potential conflict of interest: N. A. Hanania is on the speakers’ bureau for GlaxoSmithKline, AstraZeneca, and Genentech; is on advisory boards for GlaxoSmithKline, Genentech, Novartis, and Pfizer; and receives research support from GlaxoSmithKline , Genentech , Novartis , and Pfizer . M. J. King has consultant arrangements with the National Institutes of Health (NIH). R. A. Wise has consultant arrangements with AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Sunovion, and Merck and receives research support from GlaxoSmithKline , Boehringer Ingelheim , Forest , and Merck . A. R. Falsey has consultant arrangements with MedImmune and Sanofi Pasteur and receives research support from Sanofi Pasteur and GlaxoSmithKline . S. K. Mathur receives research support from the NIH and is vice-chair of the American Academy of Allergy, Asthma & Immunology (AAAAI)’s Asthma and Allergic Diseases in the Elderly committee. D. A. Stempel is employed by GlaxoSmithKline. J. J. Lima receives research support from the NIH and the American Lung Association . J. E. Fish is employed by Merck & Co, Inc. S. R. Wilson receives research support from the National Heart , Lung , and Blood Institute/NIH . C. G. Irvin is on the speakers’ bureau for Merck and the advisory board for MethaPharm, receives research support from the NIH and the American Lung Association , and is on the advisory board for the Vermont Department of Health. B. P. Yawn has consulted for the American Thoracic Society, receives research support from the Agency for Healthcare Research and Quality , and is the chair of the state coalition for asthma for the American Lung Association. S. I. Wasserman receives research support from the American Lung Association , has provided legal consultation or expert witness testimony in cases related to mold injury and medical malpractice, and is president of the American Board of Allergy and Immunology. The rest of the authors have declared that they have no conflict of interest. Funding Information: Publication of this article was supported by the National Institute on Aging .

PY - 2011/9

Y1 - 2011/9

N2 - Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.

AB - Asthma in the elderly is underdiagnosed and undertreated, and there is a paucity of knowledge on the subject. The National Institute on Aging convened this workshop to identify what is known and what gaps in knowledge remain and suggest research directions needed to improve the understanding and care of asthma in the elderly. Asthma presenting at an advanced age often has similar clinical and physiologic consequences as seen with younger patients, but comorbid illnesses and the psychosocial effects of aging might affect the diagnosis, clinical presentation, and care of asthma in this population. At least 2 phenotypes exist among elderly patients with asthma; those with longstanding asthma have more severe airflow limitation and less complete reversibility than those with late-onset asthma. Many challenges exist in the recognition and treatment of asthma in the elderly. Furthermore, the pathophysiologic mechanisms of asthma in the elderly are likely to be different from those seen in young asthmatic patients, and these differences might influence the clinical course and outcomes of asthma in this population.

KW - Aging

KW - airway

KW - allergy

KW - asthma

KW - elderly

KW - immune mechanisms

KW - immunosenescence

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JO - Journal of Allergy and Clinical Immunology

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IS - 3 SUPPL.

ER -

Asthma in the elderly: Current understanding and future research needs - A report of a National Institute on Aging (NIA) workshop

Abstract

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Keywords

ASJC Scopus subject areas

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