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Authors
Abstract(s)
Introdução: A Asma Brônquica (AB) é das doenças respiratórias mais comuns. A sua patogénese não é completamente uniforme e aceita-se que possam existir vários subtipos de asma/fenótipos, embora não estejam totalmente esclarecidos em idosos asmáticos. Assim, o objetivo deste estudo foi caracterizar clínica e funcionalmente os idosos asmáticos e identificar diferenças entre fenótipos tais como asma atópica versus não-atópica e asma de início tardio (LOA) versus asma de longa data (LSA).
Métodos: A amostra recrutada incluiu indivíduos com um diagnóstico confirmado de AB e com 65 anos ou mais, acompanhados em consulta externa hospitalar. Os voluntários assinaram o consentimento informado e responderam a questionários sobre depressão, estado cognitivo, qualidade de vida relacionada com a AB e controlo de AB. Espirometria e determinação dos níveis de óxido nítrico no ar exalado (FENO) também foram realizados. Testes cutâneos de alergia (SPT), bem como a análise dos níveis de IgE específicas de aeroalergénios (Phadiatop) foram feitos para determinar atopia. Os resultados foram analisados através do SPSS, versão 21.0.
Resultados: Foram incluídos 83 voluntários, com idade média de 73 anos (65 a 90 anos) e predominantemente do sexo feminino. A maioria era não fumadora, com excesso de peso, baixo nível de escolaridade e classe social, predominantemente urbana e reformada da indústria têxtil. A globalidade dos idosos tinha LOA e asma não atópica. A asma era mais frequentemente persistente, leve a moderada, e apenas parcialmente ou não controlada. Uma elevada percentagem de erros na técnica inalatória foram detetados. Tais factos não se refletiram na função respiratória ou na qualidade de vida. A história pessoal de doença respiratória e alergias na infância aumentou significativamente o risco do idoso ter LSA e este fenótipo foi mais frequentemente associada à co-morbilidade dermatite.
Conclusões: A maioria dos idosos asmáticos são mulheres, com asma não-atópica e LOA, com excesso de peso e relativamente boa qualidade de vida, embora esses pacientes mostrem vários erros na técnica inalatória e tenham a fazer medicação regular para o controlo dos sintomas de asma.
Background: Bronchial asthma (BA) is one of the most common respiratory diseases. Its pathogenesis is not completely uniform and it is accepted that various asthma subtypes/phenotypes may exist, although this has not been fully clarified in the elderly. Thus, the objective of the present study was to characterize clinically and functionally elderly asthmatic patients and to attempt to identify differences between some BA phenotypes, such as atopic versus non-atopic asthma and late onset (LOA) versus long standing (LSA) asthma. Methods: The target population consisted of individuals with a confirmed diagnosis of BA, who were 65 or older and were regularly seen at a hospital outpatient clinic. All volunteers signed a written informed consent and answered questionnaires on depression, cognitive state, asthma-related quality of life and asthma control. Spirometry and determination of the levels of nitric oxide in exhaled breath (FeNO) were also performed. Skin prick tests and aeroallergen-specific IgE test (Phadiatop) were used to determine atopy. Results were analyzed with the Software Package for Social Sciences (SPSS), Version 21.0. Results: A total sample of 83 volunteers was included. Mean age was 73 years (65 to 90 years), and female gender was predominant. Most patients were never smokers, with excess weight, with low level of schooling and social class, predominantly urban and retired from textile industry. Patients with LOA and non-atopic asthma predominated. Asthma was most often persistent, mild to moderate, and was only partially or not controlled. A high percentage of errors in the inhalational technique were detected. These aspects were not reflected in respiratory function or in quality of life. A personal history of respiratory illness and allergies in childhood significantly increased the risk of the elderly patient having LSA and this phenotype was more frequently associated with dermatitis as a co-morbidity. Conclusions: Most elderly asthmatic patients are female, non-atopic, have LOA and excess weight, and a relatively good quality of life, although these patients have several errors in the inhalational technique and need to take anti-asthma medication on a regular basis, for control of their symptoms.
Background: Bronchial asthma (BA) is one of the most common respiratory diseases. Its pathogenesis is not completely uniform and it is accepted that various asthma subtypes/phenotypes may exist, although this has not been fully clarified in the elderly. Thus, the objective of the present study was to characterize clinically and functionally elderly asthmatic patients and to attempt to identify differences between some BA phenotypes, such as atopic versus non-atopic asthma and late onset (LOA) versus long standing (LSA) asthma. Methods: The target population consisted of individuals with a confirmed diagnosis of BA, who were 65 or older and were regularly seen at a hospital outpatient clinic. All volunteers signed a written informed consent and answered questionnaires on depression, cognitive state, asthma-related quality of life and asthma control. Spirometry and determination of the levels of nitric oxide in exhaled breath (FeNO) were also performed. Skin prick tests and aeroallergen-specific IgE test (Phadiatop) were used to determine atopy. Results were analyzed with the Software Package for Social Sciences (SPSS), Version 21.0. Results: A total sample of 83 volunteers was included. Mean age was 73 years (65 to 90 years), and female gender was predominant. Most patients were never smokers, with excess weight, with low level of schooling and social class, predominantly urban and retired from textile industry. Patients with LOA and non-atopic asthma predominated. Asthma was most often persistent, mild to moderate, and was only partially or not controlled. A high percentage of errors in the inhalational technique were detected. These aspects were not reflected in respiratory function or in quality of life. A personal history of respiratory illness and allergies in childhood significantly increased the risk of the elderly patient having LSA and this phenotype was more frequently associated with dermatitis as a co-morbidity. Conclusions: Most elderly asthmatic patients are female, non-atopic, have LOA and excess weight, and a relatively good quality of life, although these patients have several errors in the inhalational technique and need to take anti-asthma medication on a regular basis, for control of their symptoms.
Description
Keywords
Asma Brônquica Características Clinicas Controlo da Asma Fenótipos Idoso