Advertisement  

August 13, 2014
Older Women May Need More Help Managing Asthma 

Ann Arbor, MI—Older women with asthma may need a little extra counseling from pharmacists and other healthcare providers to help manage their disease.

A recent article in the Annals of Allergy, Asthma and Immunology points out that, while the asthma rate is no greater in older women than in other segments of the population, patients in that cohort suffer a higher rate of illness and death. In fact, the asthma death rate among women older than 65 is nearly four times higher than in other groups, according to the report.

“Allergists want older women to understand that getting their asthma under control can help them control a range of other adverse health conditions,” said lead author Alan Baptist, MD, MPH, of the University of Michigan Health System. “Recent studies have shown that older women with multiple health problems admit that asthma takes a backseat to other conditions. We want them, with the help of their allergists, to view controlling their asthma as a priority.”

The article describes several factors affecting asthma management in women older than 65, including menopause and hormone replacement therapy (HRT); increased adverse effects of inhalers; depression; and reduced awareness of breathing problems.

According to the study, menopause does not increase the risk of asthma development but may, in women with a preexisting condition, increase the number of attacks. In addition, HRT can have a mixed effect, with some postmenopausal women receiving HRT demonstrating an increased risk of asthma. On the other hand, HRT is often associated with improved respiratory symptoms and decreased asthma attacks in other women with preexisting asthma, the researchers point out.

In addition, the use of inhaled corticosteroids can increase risk of osteoporosis in postmenopausal women with asthma because they often already have significantly lower bone mineral density. Other adverse effects of inhalers, including glaucoma, cataracts, and adrenal suppression, are also more common in older women, the study warns, adding that there also can be a high risk of incorrect inhaler use among elderly patients.

With women older than 65 already having depression rates ranging from 15% to 35%, severe asthma can aggravate mental health issues. The authors suggest regular screening and treatment for depression in patients struggling to bring their asthma under control.

The study also recommends self-monitoring with a peak flow meter, especially since some older asthma patients have a diminished awareness of how well they are breathing.

Additional conditions affecting older women and their management of asthma include being obese or overweight; caregiving roles that limit time to devote to self-care; and limited income or poverty, which can make it difficult to afford some recommended therapies.



U.S. Pharmacist Social Connect