Quality of life and economic features in elderly asthmatics.

BACKGROUND: In the geriatric population, asthma tends to be overlooked. Moreover, typical symptoms of asthma may mimic chronic bronchitis and emphysema.

OBJECTIVE: To compare the characteristics of asthma between elderly (>/=65 years) and adult (<65 years) asthma patients with regard to asthma severity, health-related quality of life, and direct expenditures for medical care generated by the disease.

METHODS: A cross-sectional study was made in the asthmatic population older than 14 years in the area of Barcelona, Spain. Asthma severity was determined according to the International Consensus criteria of 1992. St. George's Respiratory Questionnaire (SGRQ) was used to measure the quality of life. Direct costs were calculated registering all costs generated by each patient per year.

RESULTS: The study population consisted of 282 adult asthmatics and 51 elderly asthmatics. Asthma was more severe in the elderly group (mild 10%, moderate 35%, severe 55%) than in the adult group (mild 47%, moderate 35%, severe 18%). Elderly asthmatics had significantly higher total SGRQ scores (48 vs. 35, p < 0.001) than adult asthmatics, as well as significantly higher scores for all subscales. Asthma-derived direct costs in elderly asthmatics (mean USD 1,490 vs. USD 773) were double those in adult asthmatics, mainly due to higher costs of hospitalization and medication in the elderly.

CONCLUSIONS: Asthma in elderly people as compared with asthma in adulthood was more severe and was associated with a worse health-related quality of life, and significantly higher expenditures for medical care.