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- Hisinger-Molkanen, Hanna, et al.
(author)
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Asthma in adults : association of asthma symptoms and age at asthma diagnosis
- 2020
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In: European Respiratory Journal. - : ERS Publications. - 0903-1936 .- 1399-3003. ; 56:Suppl 64
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Journal article (other academic/artistic)abstract
- Background: Asthma may begin at any age. However, knowledge about the relationship between age at asthma diagnosis and asthma symptoms is still scarce.Objectives: To test the hypothesis that among adults, asthma diagnosed in adulthood is associated with more symptoms than asthma diagnosed in childhood.Methods: A FinEsS postal survey was conducted in a random sample of 16000 20-69-year-old adults in Finland in 2016. Age 18 years was chosen to delineate child and adult-diagnosed asthma. Current asthma was defined as physician-diagnosed asthma and asthma medication use, attacks of breathlessness or wheezing in the past year.Results: Of responders (8199, 51,5%), 692 reported current asthma and age at diagnosis. Adult-diagnosed asthma was reported by 445 (64.3%) and child-diagnosed by 247 (35.7%) responders. Those with adult-diagnosed asthma had more attacks of breathlessness in the past year (82.9% vs. 74.1%, p=0.006), dyspnea (mMRC grade ≥2) (34.4% vs. 18.8%, p<0.001) and sputum production in the past three consecutive months (40.0% vs. 27.5%, p=0.001). Of responders with adult and child-diagnosed asthma, 22.5% and 28.3% were current smokers, and 91.7% and 84.2% used asthma medication, respectively. In a logistic regression model, risk factors for attacks of breathlessness were adult-diagnosis (OR=1.8, 95% CI 1.1-3.0) and exercising <2 times a week (OR=2.0, 1.2-3.2).Conclusion: Asthmatics with adult-diagnosed asthma had significantly more symptoms even though they smoked less and used asthma medication more often compared to those with child-diagnosed asthma. Recognizing adult onset asthma in clinical practise is important to direct precise clinical care and achieve better asthma control.
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| 2. |
- Honkamaki, Jasmin, et al.
(author)
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Age at asthma diagnosis and probability of remission in a population-based study
- 2020
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In: European Respiratory Journal. - : ERS Publications. - 0903-1936 .- 1399-3003. ; 56:Suppl 64
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Journal article (other academic/artistic)abstract
- Background: Child-onset asthma is known to remit with high probability but remission in adult-onset asthma seems to be less common. Reports of association between remission and asthma onset age in adulthood are scarce.Objectives: To study if age at asthma diagnosis and gender are associated to remission rate in adult asthma population.Methods: In 2016, a random sample of 16 000 subjects aged 20-69 years from Helsinki and Western Finland were sent a FinEsS-questionnaire. Asthma was categorized by reported age when diagnosed with asthma by a physician: child (0-11 years) adolescent-young-adult (12-39 years) and late-adult-diagnosed (40-69 years). Remission was defined as a physician diagnosed asthma but not having had asthma symptoms, wheezing or use of asthma medication in the past 12 months.Results: 8199 subjects (51.5%) responded to the postal questionnaire. Remission was most common in child-diagnosed (30.2%), followed by adolescent-young-adult-diagnosed (17.9%) and least common in late-adult-diagnosed asthma (5.0%) (p<0.001). In males, the corresponding proportions were 36.7%, 20.0% and 3.4%, and in females 20.4%, 16.6% and 5.9%, respectively (p<0.001 for gender difference). In binary logistic regression, significant risk factors of non-remission were diagnosis at adolescent-young-adulthood- (OR=2.2, 95% CI 1.4-3.4) or late-adulthood- (OR=11.1, 4.8-25.4), asthma-COPD overlap (ACO) (OR=5.6, 1.3-24.5), allergic rhinitis (OR=2.3, 1.5-3.5) and family history of asthma (OR=1.9, 1.2-2.8). Results remained similar after exclusion of ACO.Conclusion: Remission was rare (5%) in adults diagnosed with asthma after age 40 years in both sexes. Causes of poor prognosis in adult-onset asthma need to be further elucidated.
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| 3. |
- Pakkasela, Johanna, et al.
(author)
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Age at asthma diagnosis in subjects with and without allergic rhinitis
- 2018
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In: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Journal article (other academic/artistic)abstract
- Background: Onset of allergic asthma has a strong association with childhood. Much less is known about adult onset asthma and its association with allergy.Objectives: To assess the proportion of allergic and non-allergic asthma in adulthood in relation to the age at asthma diagnosis.Methods: Postal questionnaires were sent to 8000 randomly selected recipients aged 20-69 years in Finland in 2016. The participation rate was 52% (n=4173). Asthma was classified allergic when a physician-diagnosed asthma and a physician-diagnosed allergic rhinitis were both reported.Results: The prevalence of physician-diagnosed asthma and allergic rhinitis were 11% (n=445) and 18%, respectively. Mean ages at diagnosis of allergic asthma and non-allergic asthma were 19 and 35 years, respectively. Among subjects with asthma diagnosis at ages 0-19, 20-39 and 50-69 years, 67%, 55% and 23%, respectively, were allergic. For non-allergic asthma, the incidence rate of asthma was lowest in children and young adults (0.7/1000/year). It increased after middle age and was highest in older age groups (2.4/1000/year in 50-59 years old).Conclusions: The study results support the well-recognized fact that childhood asthma is mostly allergic. To our knowledge, this is the first study to show that the proportion of allergic asthma steadily declines with advancing age at asthma diagnosis and non-allergic asthma becomes the dominant phenotype with asthma diagnosed in middle age.
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