D2.84 - Heterogeneity of Elderly Asthma: a nationwide health and nutrition examination survey

Elderly asthma is rising, but studies on its characteristics and impact on quality of life are scarce. Recent reports suggest most of elderly asthma are late-onset asthma which may differ from early-onset asthma. This study aimed to evaluate the demographic and clinical characteristics of elderly asthma and its differences based on the age of onset and sex.

Adult participants aged over 65 years who completed questionnaire assessments were enrolled from the Korean National Health and Nutrition Examination Survey 2010-2020. Asthma and comorbidities were defined based on the medical history of a diagnosis made by a doctor. Among elderly population, patients with asthma and without asthma were compared and subgroup analysis was performed by sex. Then, the demographic and clinical characteristics were compared among elderly asthmatics according to onset age of asthma. Additionally, k-means clustering was applied to categorize elderly asthmatics into distinct groups. 

Among 15,682 elderly subjects, 5.04% (n = 791) were diagnosed with asthma. Among elderly asthmatics, there were more old participants (≥75 years old) and female (56.4% vs. 64.7%) and they showed higher levels of depression, suicidal ideation, and stress even after adjustment for age and sex. Low income and residence in rural areas were related with the higher prevalence of asthma, particularly in males. Larger waist circumferences and being overweight, but not metabolic syndrome, were related with elderly asthma, particularly more pronounced in female patients. Among the elderly asthmatics, the disease duration of asthma were < 10 years for 59.1% and > 30 years for 11.0%. While no significant differences were observed based only on disease duration, cluster analysis identified disease duration as a significant factor, along with sex, lung function, onset age, BMI, smoking, and comorbid osteoarthritis in defining distinct cluster characteristics among elderly asthmatics. 

Elderly asthma were mostly late-onset and had significant impact on mental health. Disease duration was a meaningful factor in cluster analysis along with sex, smoking status, and lung function. The multifaceted nature of asthma in the elderly related with socioeconomic factors and comorbidities with significant gender differences suggests that managing asthma in this population requires a multidisciplinary approach.