According to the Asthma and Allergy Foundation of America, more than 25 million Americans suffer from asthma. Although approximately 75 percent of patients receive a diagnosis by age 7, some people don’t experience symptoms until adulthood — from their early 20s to their 60s, and beyond.
Although childhood and adult-onset asthma are facets of the same disease and are treated with the same medications, adults with asthma face a different set of challenges.
Adults with asthma tend to fall into one of two categories. The first includes older patients whose asthma developed during childhood or early adulthood and persisted later in life. Diagnosis for these patients is usually straightforward.
The second, less common category includes patients who first developed asthma symptoms as older adults. Diagnosing adults in this category can be challenging because the symptoms often mimic those of other illnesses. Their doctor must first rule out conditions such as chronic obstructive pulmonary disease (COPD), chronic sinusitis and congestive heart failure, often delaying the asthma diagnosis.
It is unclear why adults who never had asthma as children develop it later in life, but environmental triggers are known to play a major role. Many times, these triggers are work-related. Occupations like art, decorating, photography, technology, food preparation and cleaning may expose employees to asthma-inducing materials. Exposure to dust, gas, vapors and fumes is also associated with asthma.
Adults who experience the following symptoms may want to set up an appointment with their doctor to be screened for asthma:
- 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
- Colds that go to the chest or “hang on” for 10 days or more
After middle age, most adults’ lungs have decreased capacity. This may cause doctors to overlook adult onset asthma as a diagnosis, which can be dangerous. Untreated asthma can contribute to greater permanent loss of lung function in the long-term. Regardless of whether or not they have a history of asthma, adults experiencing new symptoms should be evaluated by their doctor.
“While adults may not be able to decrease their chances of developing asthma, they can do things to decrease the symptoms,” says Dr. Kaveh Bagheri, a pulmonologist affiliated with Sharp Grossmont Hospital. “Up to half of older people with a diagnosis of asthma are current or former smokers, so avoiding tobacco use is crucial. Avoiding exposure to other irritants can also provide significant relief.”
Managing asthma can require multiple treatments and practices to lessen symptoms. Many asthma patients use a combination of bronchodilators — medications that expand the passageways into the lungs. Short-acting bronchodilators are used as a “quick relief” or “rescue” medication, whereas long-acting bronchodilators can be used every day.
When doctors prescribe an inhaled medication to their patients, it is important to teach proper inhaler technique to ensure the drug is administered properly. Staying away from environmental triggers can provide even more relief.
“For some of my patients — especially those who never had it before — it is difficult to accept that they have asthma,” says Dr. Bagheri. “Educating them on their condition and how they can help manage it is extremely important. For a treatment plan to be successful, both patient and doctor should be actively involved.”