Main Contributory Factors on Asthma Control and Health-Related Quality of Life in Elderly Asthmatics
Enríquez-Matas A1*, Fernández-Rodríguez C1*, Andrés Esteban EM2, Fernández-Crespo J1
1Servicio de Alergia, Hospital 12 de Octubre, Instituto de Investigación Hospital 12 de Octubre (i+12), Madrid, Spain
2Instituto de Investigación Sanitaria, Unidad de Investigación Clínica, Hospital Universitario 12 de Octubre, Madrid, Spain
*Both authors contributed equally to this work.
J Investig Allergol Clin Immunol 2020; Vol 30(4)
Objective: To assess the main factors involved in asthma control and health-related quality of life in elderly asthmatic patients.
Methods: We performed a retrospective case-control study nested in a historical cohort that compared patients who had partly controlled or uncontrolled asthma (Asthma Control Test [ACT] score ≤19) (cases) with patients who had well-controlled asthma (ACT ≥20) (controls). Clinical data were collected from medical records. Outcomes included ACT score and health-related quality of life (Asthma-Specific Quality of Life Questionnaire [AQLQ]). Pulmonary function was determined by spirometry.
Results: We evaluated 209 asthma patients (151 women) aged ≥65 years. Mean age was 73.55 years. Most patients had persistent moderate (47.60%) or severe (47.12%) asthma. A total ACT score ≤19 was obtained in 64 (30.62%) patients. Lack of adherence to treatment and presence of severe exacerbations were risk factors for partly controlled/uncontrolled asthma (OR, 8.33 and 5.29, respectively). In addition, for each additional unit score in the AQLQ, the risk of poor control increased by 1.51. The factors influencing the AQLQ score were asthma control (ACT) and presence of comorbidities such as depression, gastroesophageal reflux disease, and osteoporosis.
Conclusions: Despite receiving antiasthma therapy, almost one-third of elderly patients had uncontrolled asthma, possibly as a result of poor adherence, exacerbations, and reduced health-related quality of life. Nonrespiratory comorbid conditions in older patients do not seem to be associated with worse control of asthma symptoms, although their effect on health-related quality of life could indirectly affect asthma control.
Key words: Elderly asthma, Asthma control, ACT, Comorbidity, Health-related quality of life, AQLQ, Treatment adherence