Predictors of Asthma Exacerbations in Elderly vs Nonelderly Patients

Chronic rhinosinusitis, fixed airway obstruction, and male sex are independent predictors of asthma exacerbations in patients aged ≥65 years.

Chronic rhinosinusitis (CRS), fixed airway obstruction, and male sex are independent predictors of asthma exacerbations in patients aged ≥65 years, according to study results published in Allergy, Asthma and Immunology Research.

In this study, immunology researchers from Korea analyzed patient data from an elderly asthma cohort, a Korean asthma cohort, and the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) cohort from 2015. A total of 503 elderly patients with asthma (age, ≥65 years) and 564 nonelderly patients with asthma (age, ≤65 years) were selected from the 3 cohorts and included in the final analysis. The investigators assessed specific patient characteristics and their associations with acute exacerbations during a 1-year follow-up. Comparisons were made between elderly and nonelderly patients with asthma.

During the observation period, the asthma exacerbation rates in the elderly and nonelderly cohorts were 31.0% and 33.2%, respectively. According to a multivariate logistic regression analysis, clinical variables associated with asthma exacerbations in the elderly cohort included fixed airway obstruction (adjusted odds ratio [aOR], 13.23; 95% CI, 5.96-31.61; P <.001), CRS (aOR, 3.21; 95% CI, 1.11-4.54; P =.027), and male sex (aOR, 1.89; 95% CI, 1.13-3.19; P =.015). In the nonelderly cohort with asthma, an increased eosinophil count was significantly associated with exacerbations (aOR, 1.02; 95% CI, 1.01-1.21; P =.019).

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Study limitations included the significantly higher rate of smoking in the elderly group (30.4% vs 14.2%; P <.001), the lack of data on mortality, as well as the reliance on questionnaires to obtain comorbidity information for the elderly population.

Based on their findings, the investigators advised that “pulmonary function tests should be performed regularly in the elderly and exacerbations should be responded to by more actively and comprehensively managing CRS associated risk groups.” They suggested this management would include shorter follow-up intervals and more routine drug compliance checks.


Sohn K-H, Song W-J, Park J-S, et al; on behalf of the Elderly Asthma Cohort in Korea Group. Risk factors for acute exacerbations in elderly asthma: what makes asthma in older adults distinctive? Allergy Asthma Immunol Res. 2020;12(3):443-453.