Asthma, COPD and comorbidities in elderly people

J Asthma. 2016 Nov;53(9):943-7. doi: 10.3109/02770903.2016.1170139. Epub 2016 Apr 26.

Abstract

Co-morbidities are a significant problem in the elderly population but are rarely presented and analyzed for interdependencies among the various coexisting chronic diseases.

Objective: The aim of this study was to present a profile of comorbidities in elderly patients with and without asthma and COPD.

Methods: Respondents were recruited at 20 sites in Poland. Stratified random sampling from patient databases resulted in 15,973 patients older than 60 years of age. A retrospective analysis of medical history and ICD-10 codes was performed. In addition, patients underwent a spirometry test with a bronchial reversibility test and were administered questionnaires on the prevalence of chronic diseases by doctors.

Results: The study population consisted of 1023 asthmatic patients, 1084 patients with COPD and 1076 control subjects without any signs of bronchoconstriction and with correct spirometry. Patients with asthma exhibited a similar distribution of cardiovascular and metabolic co-morbidities as the control group. However, asthmatic patients had a higher prevalence of arterial hypertension and depression with an odds ratio (OR) = 1.48 (95% CI: 1.38-1.62) and OR = 1.52 (95% CI: 1.44-1.68), respectively. Coronary disease (OR = 2.12; 95% CI: 1.97-2.33), cor pulmonale (OR = 3.1; 95% CI: 2.87-3.22) and heart failure (OR = 2.71; 95% CI: 2.64-3.11) were predominantly observed in patients with COPD. Patients with severe asthma exhibited a greater predisposition to cardiovascular and neuropsychiatric diseases.

Conclusion: Asthma coexisted frequently with arterial hypertension and depression in elderly patients. Patients with COPD have a more exaggerated profile of coexisting diseases, specifically cardiovascular problems.

Keywords: Asthma; COPD; coronary disease; depression.

MeSH terms

  • Aged
  • Asthma / complications*
  • Chronic Disease / epidemiology*
  • Comorbidity
  • Depression / epidemiology
  • Female
  • Humans
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Poland / epidemiology
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Retrospective Studies
  • Surveys and Questionnaires