Predicting asthma in older adults on the basis of clinical history

Respiratory Medicine
Rodrigo CavallazziBarbara J Polivka

Abstract

The diagnosis of asthma is not always straightforward and can be even more challenging in older adults. Asthma is ideally confirmed by demonstration of variable expiratory airflow limitation. However, many patients with asthma do not demonstrate airflow obstruction nor show bronchodilator reversibility. We aimed to investigate predictors for a positive bronchial challenge test with methacholine in older adults being evaluated for asthma. This is a diagnostic accuracy study with a cross-sectional design. Participants ≥60 years with suspected asthma and a negative postbronchodilator response on spirometry were included. All participants underwent a methacholine challenge test (MCT). We assessed the value of standard asthma screening questions and additional clinical questions to predict the MCT results. A multivariable logistic regression model was developed to assess the variables independently impacting the odds of a positive MCT result. Our study included 71 participants. The majority were female (n = 52, 73.2%) and the average age was 67.0 years. Those with a positive MCT (n = 55, 77.5%) were more likely to have wheezing or coughing due to allergens (n = 51, 92.7% vs. n = 12, 75.0%; P = 0.004) and difficulty walking several b...Continue Reading

Citations

Feb 13, 2019·Current Opinion in Allergy and Clinical Immunology·Sandra Nora González-DíazRosa Ivett Guzman-Avilan
Jun 30, 2019·Journal of the American Geriatrics Society·Maria Theresa D OpinaWendy C Moore
Jun 20, 2020·Canadian Journal of Public Health = Revue Canadienne De Santé Publique·Jessica CastnerBarbara Polivka
May 27, 2020·Journal of the American Association of Nurse Practitioners·Glenn Clinton SheddRobert Owen Calvert

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