Quality of life, health care utilization, and control in older adults with asthma

Jacqueline A Ross; Ye Yang; Peter X K Song; Noreen M Clark; Alan P Baptist

doi:10.1016/j.jaip.2012.12.003

Quality of life, health care utilization, and control in older adults with asthma

J Allergy Clin Immunol Pract. 2013 Mar;1(2):157-62. doi: 10.1016/j.jaip.2012.12.003. Epub 2013 Feb 4.

Authors

Jacqueline A Ross¹, Ye Yang², Peter X K Song², Noreen M Clark³, Alan P Baptist⁴

Affiliations

¹ Department of Internal Medicine, Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Mich.
² Center for Managing Chronic Disease, School of Public Health, University of Michigan, Ann Arbor, Mich; Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Mich.
³ Center for Managing Chronic Disease, School of Public Health, University of Michigan, Ann Arbor, Mich.
⁴ Department of Internal Medicine, Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Mich; Center for Managing Chronic Disease, School of Public Health, University of Michigan, Ann Arbor, Mich. Electronic address: abaptist@med.umich.edu.

PMID: 24565454
DOI: 10.1016/j.jaip.2012.12.003

Abstract

Background: Older adults with asthma have worse quality of life, asthma control and increased health care utilization than do healthy peers. Factors that contribute to this are currently unknown.

Objective: To identify demographic, psychological or physiologic characteristics associated with asthma quality of life, control and health care utilization in older adults.

Methods: By using a cross-sectional design, subjects older than 65 years with a history of physician-diagnosed asthma were enrolled. Demographic, psychological and physiological characteristics (including spirometry, atopy testing and exhaled nitric oxide) were collected. Correlations between these factors and the mini Asthma Quality of Life Questionnaire, Asthma Control Questionnaire and health care utilization were assessed.

Results: Seventy subjects were enrolled in the study, with a mean age of 73.3 years and mean duration of asthma diagnosis of 28.5 years. Higher depression screening scores and self-reported depression were strongly correlated with poorer quality of life and asthma control after controlling for confounding effects through a regression model. In addition, worse overall functional status was correlated with poorer asthma quality of life (P < .01), presence of atopy was associated with decreased health care utilization (P < .01) and subjects who lived alone were more likely to have unscheduled visits to a physician's office (P = .06).

Conclusions: Comorbid depression is strongly associated with poorer asthma quality of life and control in older adults. In addition, worse functional status and living alone may be associated with poorer outcomes. Screening for these conditions is important in the care of the elderly asthmatic population.

Keywords: Asthma; Asthma control; Depression; Elderly; Health care utilization; Living situation; Older adults; Quality of life.

MeSH terms

Aged
Aged, 80 and over
Asthma / psychology
Asthma / therapy*
Cross-Sectional Studies
Delivery of Health Care / statistics & numerical data*
Female
Humans
Male
Middle Aged
Quality of Life*
Regression Analysis