HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text (PDF) All Versions of this Article: chest.06-2824v1 132/4/1175    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bellia, V. Articles by Antonelli Incalzi, R. Search for Related Content PubMed PubMed Citation Articles by Bellia, V. Articles by Antonelli Incalzi, R.

Asthma in the elderly: Mortality rate and associated risk factors for mortality

¹Università degli studi di Palermo: Dipartimento di Medicina e pneumologia fisiologia della nutrizione umana (DIMPEFINU). Via trabucco 180; 90146 Palermo (Italy) ²Area di geriatria Università campus Biomedico; Via Dei Compositori 130; 00128 Rome (Italy) ³ A.O. V. Cervello. II divisione di Pneumologia.Via Trabucco 180; 90146 Palermo ( Italy) ⁴ Dipartimento di Epidemiologia, ASL Roma E Via Santa Costanza 53; 00198 Roma (Italy)

v.bellia{at}unipa.it

Abstract

BackgroundThere is a distinct lack of information on the prognosis of asthma in the elderly.

MethodsIn order to compare the mortality of elderly people with and without asthma and to identify risk factors for mortality in those with asthma, 1233 ambulatory patients aged 65 or older with a diagnosis of asthma (N=210) or chronic non respiratory conditions (N=1023), were enrolled in the Sa.R.A. multicentric study. Patients underwent baseline spirometry and multidimensional assessment and were then followed up for a mean of 57.9 months (SD: 16.9). We compared mortality in the two groups and identified predictors of death using multivariable survival analysis.

ResultsFive-years mortality in people with asthma was 24.3%, compared to 16.3% in controls (P<0.01), but asthma per se did not explain the excess risk of death. The main causes of death among people with and without asthma were cardiovascular diseases (36.4% and 21.3%, respectively), non-neoplastic lung diseases (28.8% vs. 5.4%) and neoplasms (7.6% vs. 22.6%). In people without asthma, mortality was associated with age, gender, smoking, cardiovascular diseases, worse performance at the 6' walking test, cognitive impairment, depression, and worse respiratory function. In people with asthma, only the association between mortality and age, smoking and depression was confirmed. At variance with controls, in asthmatics we found an inverse correlation between being overweight and mortality (HR: 0.35; 95% CI: 0.13 – 0.94) and a trend towards a higher mortality in people with a BMI<22 (HR: 2.21; 95% CI: 0.94 – 5.18).

ConclusionsAsthma in the elderly was associated with higher mortality, although this condition was not an independent risk factor. Causes of death and factors associated with mortality where somewhat different between people with and without asthma.

Key Words: Mortality • Asthma • Depression • Geriatrics • Nutrition malnutrition,