With one in nine Australians affected, asthma prevalence in Australia is higher than in comparable Western countries such as the UK and US.
Asthma is a chronic respiratory condition that can vary throughout a person’s lifetime. Though many cases are diagnosed early in life, asthma can go undiagnosed or develop in adulthood.
Many people do not realise the seriousness of asthma and may not be aware that it can be life-threatening at any age. Older women are most at risk of dying from asthma, with those over 75 at greatest risk.
In 2010, the Australian Institute of Health and Welfare (AIHW) released a report, Asthma Among Older People in Australia,1 which noted that there are two broad patterns of asthma prevalence over the life course, and the older pattern begins at about 45 years of age.
Around 400 deaths occur due to asthma in Australia each year, and about 90 per cent of these are in people over 45.
A 2015 report also showed that 45 per cent of people with asthma are not managing their condition well. Those with poorly managed asthma are more likely to experience regular symptoms and impacts on daily life.
It’s important that older Australians with diagnosed asthma keep on top of their medication routine and see their doctor for an annual asthma review. Asthma symptoms can change with age, so adjustments in treatment may be needed. Asthma should not stop someone from performing activities they enjoy, and physical fitness is important for maintaining good health for people with asthma.
Unfortunately, a 2016 report by the AIHW3 found that people with asthma are more likely to report obesity (36 per cent vs 27 per cent) and physical inactivity (62 per cent vs 54 per cent) than those without asthma.
Poorly managed asthma not only creates an increased risk of severe flare-ups and trips to hospital but can also affect family relationships, mental health and general wellbeing.
We’d strongly encourage anyone who has asthma and is finding that it gets in the way of life to discuss their symptoms and management with their doctor.
The trick is recognising when asthma is getting worse. It’s so easy for people to normalise their symptoms. With older people it can help for family members and carers to keep an eye on symptoms such as coughing, wheezing and breathlessness.
A useful benchmark is if a person with asthma regularly needs to use their reliever puffer on more than two days per week, their asthma is not well managed. This means it’s time to talk to the doctor.
There is also the issue of undiagnosed asthma in older people. It’s important for older people and those caring for them to understand that breathlessness is not a normal part of ageing. This and other symptoms including persistent cough and tightness in the chest could indicate asthma.
Some asthma symptoms, for example chest tightness, may be similar to other conditions common in an older population, and to add to this complexity there are common comorbidities that may be present alongside asthma. Sixty-three per cent of people aged over 65 with asthma report they experience cardiovascular disease.
The good news is that with a diagnosis, a management plan and good medication practices, older people with asthma can continue to lead an active and fulfilling life.
We see examples of this in the older Australians we meet through our work providing training, advice and support to people with asthma in communities across Australia and through our national helpline.
For example, Sam, 74, recently completed a 100km walk over five days to raise funds to support others with asthma.
As a child, Sam experienced some asthma symptoms, but it wasn’t until a serious asthma attack when he was in his 40s that he began regular asthma treatment. As well as his interest in bushwalking, Sam is part of a seniors’ athletics club where he participates in javelin throwing.
Sam is keen to encourage others not to let asthma hold them back. With good asthma management and listening to your body, Sam says people with asthma can “get up and get into life”.
Unfortunately, there is no cure for asthma and no quick fix. That said, we are fortunate because for most people with asthma the current treatments work well.
It is vital that people with asthma persevere. What I mean by this is don’t put up with symptoms and don’t be afraid to go back to the doctor if symptoms persist.
Perseverance also means taking a long-term view. This is important with preventer treatment, which may take time to work its magic but offers the best protection long term – which is why it needs to be taken regularly and consistently, not stopped when the person feels better.
We know that living with asthma, finding the right treatment and dealing with related issues can be tough. That’s why Asthma Australia offers training for workplaces, and support through our COACH program and the national 1800 ASTHMA Helpline (1800 278 462). While we continue to work towards a cure, we are also committed to helping people with asthma to breathe better, and live better, every day.
Michele Goldman is CEO of Asthma Australia. For more information about asthma visit asthmaaustralia.org.au
‘Asthma among older people in Australia’, AIHW, 20 May 2010
Med J Aust 2015; 202 (9): 492-496
‘Asthma, associated comorbidities and risk factors’, AIHW. Last updated 23 Aug 2016Do you have an idea for a story?
Email [email protected]