Drugs & Aging

, Volume 30, Issue 1, pp 1–17

Managing Older Patients with Coexistent Asthma and Chronic Obstructive Pulmonary Disease

Diagnostic and Therapeutic Challenges
  • Vanessa M. McDonald
  • Isabel Higgins
  • Peter G. Gibson
Review Article

DOI: 10.1007/s40266-012-0042-z

Cite this article as:
McDonald, V.M., Higgins, I. & Gibson, P.G. Drugs Aging (2013) 30: 1. doi:10.1007/s40266-012-0042-z

Abstract

Asthma and chronic obstructive pulmonary disease (COPD) are common obstructive airway diseases, especially among older people. These conditions are associated with a significant and increasing disease burden. The diagnosis and management of asthma and COPD in older populations are complex, and consequently clinicians are faced with many therapeutic and diagnostic challenges. Both aging and obstructive airway diseases are associated with complex co-morbidities and these coexisting illnesses confound management. Moreover, the age-related physiological changes that occur in the lungs may lead to airflow limitation, and this may be difficult to distinguish from an active disease state. In practice, management of asthma and COPD is informed by disease-specific clinical practice guidelines; however, most older people with these conditions are excluded from clinical trials that are designed to inform practice, creating major evidence gaps. Furthermore, seldom do clinical practice guidelines consider the complexities of management in older populations. The problems experienced by older people are complex and multifactorial and our approach to management must reflect these challenges. Opportunities exist to improve the management and outcomes for older people with obstructive airway disease and there is an urgent need for clinical trials to test management approaches in this population; current research must consider the challenges and evidence gaps that exist.

Copyright information

© Springer International Publishing Switzerland 2012

Authors and Affiliations

  • Vanessa M. McDonald
    • 1
    • 2
    • 3
    • 4
  • Isabel Higgins
    • 3
  • Peter G. Gibson
    • 1
    • 2
    • 4
    • 5
    • 6
  1. 1.Priority Research Centre for Asthma and Respiratory DiseasesUniversity of NewcastleNewcastleAustralia
  2. 2.School of Medicine and Public Health, Faculty of HealthUniversity of NewcastleNewcastleAustralia
  3. 3.School of Nursing and Midwifery, Faculty of HealthUniversity of NewcastleNewcastleAustralia
  4. 4.Department of Respiratory and Sleep MedicineJohn Hunter HospitalNew LambtonAustralia
  5. 5.Woolcock Institute of Medical ResearchSydneyAustralia
  6. 6.Level 2 West WingHunter Medical Research InstituteNew LambtonAustralia