Risk of adult-onset asthma increases with the number of allergic multimorbidities and decreases with age

Allergy. 2019 Dec;74(12):2406-2416. doi: 10.1111/all.13971. Epub 2019 Jul 24.

Abstract

Background: The aim was to study the association between allergic multimorbidity and adult-onset asthma considering the number of allergic diseases and the age effect.

Methods: We used population-based data from Finnish national registers including 1205 adults over 30 years of age with recently diagnosed asthma (age range: 30-93), matched for gender, age, and living region with one or two controls (n = 2050). Allergic rhinitis (AR), allergic conjunctivitis (AC), and allergic dermatitis (AD) were defined from self-completed questionnaire. Conditional logistic regression adjusted on potential confounders (smoking, growing in countryside, childhood hospitalized infection/pneumonia, parental asthma/allergy, parental smoking, education level, professional training, number of siblings, and birth order) was applied to estimate the asthma risk associated with allergic multimorbidity.

Results: A total of 1118 cases with asthma and 1772 matched controls were included [mean (SD, min-max) 53 (11, 31-71) years, 37% men)]. AR, AC, and AD were reported by 50.2%, 39.6%, and 33.8%, respectively, among subjects with asthma and 26.1%, 20.0%, and 23.5%, respectively, among controls. Compared to nonatopics, adult-onset asthma increased with the number of allergic diseases; adjusted OR for asthma [95% CI] associated with 1, 2, and 3 allergic diseases was 1.95 [1.52-2.49], 2.87 [2.19-3.77], and 4.26 [3.07-5.90], respectively. The association between adult-onset asthma and ≥ 1 allergic multimorbidity decreased with increasing age (3.52 [2.51-4.94], 2.44 [1.74-3.42], and 1.68 [1.04-2.71]) in subjects < 50 years, 50-62 years, and > 62 years, respectively (p for age*≥1 allergic multimorbidity interaction, 0.002).

Conclusions: Adult-onset asthma was positively associated with the number of allergic diseases, and this association decreases with age.

Keywords: Asthma; atopic dermatitis; epidemiology; ocular allergy; rhinitis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Asthma / epidemiology*
  • Asthma / etiology
  • Case-Control Studies
  • Cross-Sectional Studies
  • Disease Susceptibility
  • Female
  • Humans
  • Hypersensitivity / epidemiology
  • Male
  • Middle Aged
  • Multimorbidity
  • Odds Ratio