A guide to living with asthma for people aged 65 years and over
Older adults can have asthma too. Some people develop asthma for the first time in later adulthood. If you experience and breathing problems, make sure to inform your doctor, because undiagnosed asthma is risky, or the problem could be something else.
If you were diagnosed with asthma, quit smoking and avoid other people’s tobacco smoke.
You should also follow your written asthma action plan. If you don’t have one, take a printed copy to your doctor and ask him to make one for you. You can download a printable version here.
Tell your doctor about all the medicines you are taking for other medical conditions. You should also ask him, the nurse or pharmacist to show you exactly how to use your asthma inhaler correctly.
Tell your doctor if you:
- have any trouble using an inhaler or are unsure of how to use it
- have any concerns about a medicine
- think that your asthma medicines are causing side-effects
Asthma in later adulthood
Asthma is just as common in people aged 65 years or older as it is in all adults. This includes people who first get asthma in later life, as well as people who have had asthma all their lives.
About half of all people with asthma aged 75 years or more have not been diagnosed by a doctor.
Many older people don’t mention a breathing problem to their doctor because they think it’s just due to age, lack of fitness, being overweight, or some other health problem.
Untreated asthma is especially risky in older people. People of any age should tell their doctor if they ever have shortness of breath, a whistling sound when they breathe, or a tight feeling in the chest..
Ageing and lung function
Lung function is measured by how well a person can fill their lungs with air, and how hard and fast they can breathe out. Lungs develop throughout childhood and early adulthood, reaching peak performance by about age 20–25 years. Lung function is gradually lost throughout adulthood. Typically, men lose lung function faster than women.
As a person ages, the lungs and muscles have to work harder to breathe as muscles used for breathing can become weaker. For most people, this is not a problem – they may just get breathless more easily when they exercise.
Untreated asthma can make a person’s lung function worsen faster. Over many years, this becomes a health problem.
Looking after your lungs is important, because unhealthy lungs can spoil your quality of life, by making it harder to take part in everyday activities
Doing spirometry (breathing test)
The spirometry test involves blowing air through a mouthpiece into a machine (spirometer). The machine measures the amount of air you can breathe in and out of your lungs, and how hard and fast you can breathe out.
If your doctor uses a spirometer to test your breathing, you will usually be asked to follow these steps:
- Sit upright in a chair with your legs uncrossed and your feet flat on the ground
- Breathe in completely and rapidly
- Put the mouthpiece in your mouth and close your lips firmly around it so no air escapes
- Breathe out as fast and as hard as you can, until your lungs are completely empty, or until you cannot blow out any more air
Adults of any age can do the spirometry test. Your doctor or a trained operator will explain everything you need to do. It is a good idea to go to the toilet before the test. You will need to blow out air from your lungs very forcefully, which will be easier if you don’t have to think about your bladder.
Taking care of yourself if you have asthma
Asthma is a long-term medical condition. It is still there even when the person is not experiencing symptoms or having an asthma ‘attack’. This means you need to keep managing your asthma all the time, not just when you are troubled by symptoms.
Managing your asthma means avoiding tobacco smoke, avoiding other things that worsen your symptoms, having your asthma checked by a doctor from time to time, taking any prescribed asthma medicines exactly as instructed, and following your written asthma action plan.
Smoking harms your lungs at any age. Don’t smoke (and avoid other people’s tobacco smoke) because smoke can:
- trigger asthma ‘attacks’
- make your asthma harder to control (even if you don’t feel it)
- cause permanent damage to your lungs
If you smoke, try to quit. It is never too late – quitting can improve your health at any age. Also, older people can successfully quit smoking, and may even be better at staying smoke-free than younger adults.
Know how to take your asthma medicines correctly
Anyone who takes asthma medicines using an inhaler or ‘puffer’ needs careful training to use them properly as using inhalers the wrong way can make asthma medicines less effective.
Some older people are unable to breathe in strongly enough to get sufficient amounts of medicine into their lungs. Some have trouble connecting their puffer to a spacer and some have trouble using their hands due to arthritis.
Different types of inhalers suit different people. You should work with your doctor to find the type of inhaler that is easiest for you to use. Ask your doctor or pharmacist to watch you take it to make sure you are using it correctly.
Tell your doctor if you have any trouble using an inhaler, have any concerns about a medicine, or think that your asthma medicines are causing side-effects.
Follow your written asthma action plan
You should never ignore or ‘put up with’ asthma symptoms, because asthma ‘attacks’ are very risky –especially for people over 65 years.
A written asthma action plan tells you which medicines to take, what to do when you have symptoms (or your asthma worsens over a few days), and what to do in an emergency.
If you don’t have a personal written asthma action plan, ask your doctor to write one for you. You can download a printable version here and take it to your doctor to fill it up with you.
Managing asthma when you have other medical conditions
Most older people will have one or more health conditions, and many are taking one or more medicines regularly.
Whenever you start taking any new medicine for asthma or another condition, make sure your doctor and your pharmacist know about all the other medicines you are taking, including any over-the-counter or complementary medicines you use.
Some medicines can cause asthma symptoms. Common examples are:
- blood pressure-lowering medicines that end with the letters L-O-L, such as atenolol, bisoprolol, carvedilol, labetolol, metoprolol, and pindolol
- eye drops for glaucoma, such as betaxolol, carbachol, timolol, and pilocarpine
Tell your pharmacist if you have asthma and you are taking any of these medicines.
Some common medical conditions can make asthma worse or harder to manage. Tell your doctor if you have any of these health problems:
- gastroesophageal reflux (stomach reflux)
- breathing problems during sleep (such as snoring or obstructive sleep apnea)
- depression
- anxiety
- overweight
- memory problems
- poor physical fitness
Some people with asthma have other lung conditions at the same time. One lung condition that is fairly common among older people is chronic obstructive pulmonary disease (usually called COPD). Pulmonary rehabilitation is recommended for people who have COPD as well as asthma.
