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Adult Onset of Asthma

Asthma image
Many people develop asthma in childhood. However, asthma symptoms can appear at any time in life.

Many people develop asthma in childhood. However, asthma symptoms can appear at any time in life. Individuals who develop asthma as adults are said to have adult onset asthma. It is possible to first develop asthma at age 50, 60, or even later in life.

Adult onset asthma may or may not be caused by allergies. Some individuals who had allergies as children or young adults with no asthma symptoms could develop asthma as older adults. Other times, adults become sensitized to everyday substances found in their homes or food and suddenly begin to experience asthma symptoms. About 50 percent of older adults who have asthma also have allergies.

Signs & Symptoms of Adult Onset Asthma
Asthma symptoms can include dry cough, especially at night or in response to specific “triggers”; tightness or pressure in the chest; difficulty breathing; wheezing (a whistling sound) when exhaling; shortness of breath after exercise; and colds that go to the chest or “hang on” for 10 days or more.

How Adult Onset Asthma Compares with Childhood Asthma
Unlike children who often experience intermittent asthma symptoms in response to allergy triggers or respiratory infections, adults with newly diagnosed asthma generally have persistent symptoms. Daily medications may be required to keep asthma under control.

After middle age, most adults experience a decrease in their lung capacity. These changes in lung function may lead some physicians to overlook asthma as a possible diagnosis. Untreated asthma can contribute to even greater loss of lung function.

Diagnosis of Adult Onset Asthma
Asthma symptoms can mimic other illnesses or diseases – especially in older adults. Hiatal hernia, stomach problems, or rheumatoid arthritis can create asthma-like symptoms. Chronic obstructive pulmonary disease (COPD) has many of the same symptoms as asthma. COPD, which includes emphysema and chronic bronchitis, is very common in older adults, especially those who are or have been smokers.

If your asthma symptoms are caused by allergies,
take steps to control known or potential triggers in your environment.

To diagnose asthma, your physician will question you about your symptoms, do a physical exam, and conduct lung function tests. In addition, you may be tested for allergies. Your primary care physician may refer you to a pulmonologist or an allergist for specialized testing or treatment.

If you have any asthma symptoms, don’t ignore them or try to treat them yourself. Get a definitive diagnosis from your healthcare provider.

Managing Adult Onset Asthma
There are four key steps to successfully managing asthma:

  1. Learn about asthma and stay up-todate on new developments.
  2. Take prescribed medications. Don’t make any changes until you check with your doctor. Don’t use over-the-counter medications unless prescribed by your doctor. Check your lungs daily at home with a peak flow meter.
  3. You often can detect changes in your lungs with a peak flow meter before you actually feel your symptoms increasing. Visit your doctor regularly for further in-office tests. These lung tests are painless and provide valuable data that help your physician make adjustments in your medications.
  4. Make an asthma management plan with your healthcare provider. A plan establishes guidelines that tell you what to do if your asthma symptoms get worse.

Controlling Asthma Symptoms
If your asthma symptoms are caused by allergies, take steps to control known or potential triggers in your environment. Allergy-proof your house for dust, mold, cockroaches, and other common indoor allergens to which you are allergic. Reduce your outdoor activities when pollen counts or ozone levels are high. Choose foods that don’t contribute to your asthma or allergy symptoms. Evaluate your workplace for possible allergens, and take the necessary steps to reduce your exposure to them.

Special Considerations for Adults with Asthma
Many adults take several medications or use over-the-counter medications, such as ibuprofen or aspirin, regularly. Work with your doctor to simplify your medication program as much as possible. Explore the possibility of combining medications or using alternate ones that will have the same desired effect. Be sure to discuss potential drug interactions with anything you take, including vitamins.

Some asthma medications increase heart rate. If you have a heart condition, discuss those side effects with your healthcare provider. Older “first generation” antihistamines can cause men with enlarged prostates to retain urine. Oral steroids can make symptoms of glaucoma, cataracts, and osteoporosis worse.

Adults with arthritis may need special inhalers that are easier to operate. Anyone with asthma should consider getting an annual flu shot. Older adults also should talk with their doctor about getting a pneumonia vaccination. People with multiple medical conditions need to be aware of how their illnesses may affect one another.


Source: Asthma and Allergy Foundation of America,

This article was originally published in Coping® with Allergies & Asthma magazine, Spring/Summer 2011.