Jonathan Burdon1. 1. AM, MBBS, MD, M Hlth and Med Law, FRACP, FCCP, FACLM, FAICD, Consultant Respiratory Physician, Mercy Private Hospital, East Melbourne, VIC; Chairman, National Asthma Council Australia, South Melbourne, VIC.
Abstract
BACKGROUND: Asthma is commonly overlooked or misdiagnosed in adults. Adult-onset asthma differs from asthma that first occurs in childhood as it is less well controlled, more likely to be non-atopic and associated with a faster decline in lung function. Risk factors include exposure to sensitising or irritant substances, obesity, pharmaceutical agents, rhinitis, environmental pollutants, respiratory tract infections and psychological stress. OBJECTIVE: The aim of this article is to provide an overview of adult-onset asthma. DISCUSSION: The clinical presentation of adult-onset asthma is similar to that in any age group. Care needs to be taken to differentiate it from chronic obstructive pulmonary disease and other conditions with similar symptoms. Measurement of reversible airflow obstruction, as demonstrated by an increase in forced expiratory volume in 1 second (FEV1) following inhalation of a short-acting beta-2 agonist (eg salbutamol) of more than 200 ml or 12%, or a positive provocation test is needed to confirm the diagnosis. Management of asthma in adults is based on confirming the diagnosis, assessing the symptoms and their control, asthma education and establishing treatment goals.
BACKGROUND:Asthma is commonly overlooked or misdiagnosed in adults. Adult-onset asthma differs from asthma that first occurs in childhood as it is less well controlled, more likely to be non-atopic and associated with a faster decline in lung function. Risk factors include exposure to sensitising or irritant substances, obesity, pharmaceutical agents, rhinitis, environmental pollutants, respiratory tract infections and psychological stress. OBJECTIVE: The aim of this article is to provide an overview of adult-onset asthma. DISCUSSION: The clinical presentation of adult-onset asthma is similar to that in any age group. Care needs to be taken to differentiate it from chronic obstructive pulmonary disease and other conditions with similar symptoms. Measurement of reversible airflow obstruction, as demonstrated by an increase in forced expiratory volume in 1 second (FEV1) following inhalation of a short-acting beta-2 agonist (eg salbutamol) of more than 200 ml or 12%, or a positive provocation test is needed to confirm the diagnosis. Management of asthma in adults is based on confirming the diagnosis, assessing the symptoms and their control, asthma education and establishing treatment goals.