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1 From the Istituto di Fisiopatologia Respiratoria del C.N.R. and Istituto di Pneumologia dell'Università, Palermo, Italy
Vincenzo Bellia, MD, Clinica Pneumologica dell'Università, via Trabucco 180, 90146 Palermo, Italy
Objective: In a cross-sectional study we evaluated the effect of aging (separately from that of duration of disease) on airway obstruction and reversibility by comparing two groups of non-smoker patients with asthma.
Methods: We compared two groups of patients: group A, which had 50 subjects (8 men and 42 women) aged 59.7 ± 4.6 years (mean ± SD), and group B, comprised of 51 subjects (19 men and 32 women) who were 35.7 ± 7.4 years old. The groups were selected because of comparable baseline degree of obstruction (FEV1 % of predicted, 67.8 ± 20.3 in group A; 73.0 ± 19.6 in group B, NS) and duration of the disease (14.0 ± 11.7 years vs 11.2 ± 9.1, NS). Spirometric examination, with a bronchodilator test, was performed and subjects not reaching 85% of predicted were submitted to a 4-week course of inhaled steroids.
Results: Although a higher number of subjects from group B responded to the acute bronchodilator test (p < 0.001), the maximum response achievable with treatment (steroid or bronchodilator) (
FEV1 expressed as the percent of predicted) was not statistically different between groups (12.0 ± 17.5 vs 16.0 ± 23.9). The mean FEV1 attainable after treatment FEV1 PT) was significantly lower in the older group (p = 0.0006). Within groups, the baseline FEV1% did not correlate with age; it was inversely correlated with the duration of the disease (p < 0.03 and p < 0.01, respectively). In both groups FEV1 was inversely related with the baseline FEV1 whereas FEV1 %PT was correlated with the duration of the disease, with a slope nearly doubled in group B (p < 0.001).
Conclusions: Both the process of aging and the prolonged exposure to disease effects are important factors in determining the functional characteristics of chronic asthma: In particular, aging is associated not only with a reduced acute responsiveness to bronchodilators, but also with a reduced slope of the duration-FEV1%PT relationship that suggests a slowing of the rate of loss of reversibility of uncertain biological meaning.
Key Words: aging • airway obstruction • asthma • elderly • functional decline • reversibility
Submitted on June 17, 1997
Accepted on June 18, 1998
This article has been cited by other articles:
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  A.M. Vignola, A. Bonanno, M. Profita, L. Riccobono, N. Scichilone, M. Spatafora, J. Bousquet, G. Bonsignore, and V. Bellia Effect of age and asthma duration upon elastase and {alpha}1-antitrypsin levels in adult asthmatics Eur. Respir. J., November 1, 2003; 22(5): 795 - 801. [Abstract] [Full Text] [PDF]
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 F. Cibella, G. Cuttitta, V. Bellia, S. Bucchieri, S. D'Anna, D. Guerrera, and G. Bonsignore Lung Function Decline in Bronchial Asthma Chest, December 1, 2002; 122(6): 1944 - 1948. [Abstract] [Full Text] [PDF]
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G. Cuttitta, F. Cibella, V. Bellia, V. Grassi, S. Cossi, S. Bucchieri, and G. Bonsignore Changes in FVC During Methacholine-Induced Bronchoconstriction in Elderly Patients With Asthma : Bronchial Hyperresponsiveness and Aging Chest, June 1, 2001; 119(6): 1685 - 1690. [Abstract] [Full Text] [PDF]
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