New Guidelines for Controlling Asthma in Older Women

Older women with asthma suffered more than men their age with the condition

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Asthma can be difficult to deal with for anyone at any age. But older women may suffer more from the condition than other groups.

Women older than 65 get sicker more often from asthma and, as a group, die from asthma at four times the rate of other groups of asthmatics, according to a new set of guidelines aimed at helping such women better control their asthma.

"Ask your allergist about managing asthma."

This lead author of the new guidelines and research was Alan Baptist, MD, MPH, of the University of Michigan Medical School in Ann Arbor.

For this investigation, Dr. Baptist and two other researchers analyzed the impact of such coexisting illnesses as obesity on women 65 or older who had asthma. They also considered how poverty, caregiving for others and other life issues affected female asthma patients. As a group, women in the US are more likely than men to be poor and to be primary caregivers for the young, old and sick.

Partly relying on previous studies, the researchers for this new study offered these, among other, suggestions for this group of older female asthmatics:

  • Consult with an allergist on the benefits and harms of using hormone replacement therapy after menopause. Asthma symptoms and severity lessened for some, but not all, postmenopausal asthmatic women undergoing hormone replacement therapy.
  • Know the potential risks of corticosteroid inhalers, which many doctors consider the best treatment for asthma. Nevertheless, inhalers can speed up bone density loss (osteoporosis) for women already dealing with frail bones.
  • Get screened and, if necessary, treated for depression. Depression is a risk for those with the severest forms of asthma and a greater risk for women than for men.
  • Control the common fear of running out of breath, and take action if symptoms persist. A portable peak flow meter can measure lung and breathing capacity.

The authors of these guidelines said their advice to older women with asthma was based on existing data reflecting a gender divide in asthma. For example, in 2011, 9.1 percent of women older than 65 and 5.7 percent of men in that age group had asthma. From 2007 to 2009, the death rate for older women with asthma was 30 percent higher than that of older men. Women older than 65 were almost twice as likely as men their age to end up in the emergency room because of an asthma attack, the researchers wrote.

Those differences may be linked to a lack of self-care for asthma due to the many obligations that some women have on their plates, whether other illnesses or financial distress, the authors added.

"Allergists want older women to understand that getting their asthma under control can help them control a range of other adverse health conditions," Dr. Baptist said in a press release. "Recent studies have shown that older women with multiple health problems admit that asthma takes a backseat to other conditions. We want them, with the help of their allergists, to view controlling their asthma as a priority."

To expand upon their suggestions for how older female asthmatics might better control their asthma, the researchers said that menopause does not raise a woman’s chances of developing asthma. However, for some women who had asthma prior to menopause, asthma attacks became more frequent after they completed menopause. Hormone replacement therapy worsened asthma for some women, but it improved respiratory health and cut the number of attacks in other women.

One previous study linked hormone replacement therapy with a doubling of new asthma cases.

Researchers also said using inhalers raised the risks of developing cataracts and glaucoma, eye conditions that can impair vision and cause blindness. Inhalers also can suppress the adrenal system, which helps regulate the body's metabolism, blood pressure and blood sugars.

Because some elderly patients don’t use their inhalers correctly, the researchers added, those patients might be helped by an asthma educator who trains people in correct inhaler usage.

The study was published online August 1 in the Annals of Allergy, Asthma and Immunology.

The National Institute on Aging funded the study. The researchers received grants from the National Institutes of Health and various pharmaceutical companies — for which some of the authors worked as consultants.

Review Date: 
July 31, 2014
Last Updated:
August 1, 2014