Age at asthma diagnosis is related to prevalence and characteristics of asthma symptoms

Hanna Hisinger-Mölkänen; Jasmin Honkamäki; Hannu Kankaanranta; Leena Tuomisto; Helena Backman; Heidi Andersen; Ari Lindqvist; Lauri Lehtimäki; Anssi Sovijärvi; Eva Rönmark; Paula Pallasaho; Pinja Ilmarinen; Päivi Piirilä

doi:10.1016/j.waojou.2022.100675

Age at asthma diagnosis is related to prevalence and characteristics of asthma symptoms

World Allergy Organ J. 2022 Sep 16;15(9):100675. doi: 10.1016/j.waojou.2022.100675. eCollection 2022 Sep.

Authors

Hanna Hisinger-Mölkänen¹, Jasmin Honkamäki², Hannu Kankaanranta^{2

3

4}, Leena Tuomisto³, Helena Backman⁵, Heidi Andersen⁶, Ari Lindqvist⁷, Lauri Lehtimäki^{2

8}, Anssi Sovijärvi^{1

9}, Eva Rönmark⁵, Paula Pallasaho¹⁰, Pinja Ilmarinen³, Päivi Piirilä^{1

9}

Affiliations

¹ Faculty of Medicine, University of Helsinki, Helsinki, Finland.
² Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
³ Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland.
⁴ Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
⁵ Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine/ the OLIN Unit, Umeå University, Umeå, Sweden.
⁶ Karolinska University Hospital, Thoracic Oncology Unit, Tema Cancer, Stockholm, Sweden.
⁷ Clinical Research Unit of Pulmonary Diseases, Helsinki University Hospital, Helsinki, Finland.
⁸ Allergy Centre, Tampere University Hospital, Tampere, Finland.
⁹ Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland.
¹⁰ Espoo City Health Services, Espoo, Finland.

Abstract

Background: Although asthma may begin at any age, knowledge about relationship between asthma age of onset and the prevalence and character of different symptoms is scarce.

Objectives: The aim of this study was to investigate if adult-diagnosed asthma is associated with more symptoms and different symptom profiles than child-diagnosed asthma.

Methods: A FinEsS postal survey was conducted in a random sample of 16 000 20-69-year-old Finnish adults in 2016. Those reporting physician-diagnosed asthma and age at asthma diagnosis were included. Age 18 years was chosen to delineate child- and adult-diagnosed asthma.

Results: Of responders (N = 8199, 51.5%), 842 (10.3%) reported asthma diagnosis. Adult-diagnosed asthma was reported by 499 (59.3%) and child-diagnosed by 343 (40.7%). Of responders with adult-diagnosed and child-diagnosed asthma, 81.8% versus 60.6% used asthma medication (p < 0.001), respectively. Current asthma was also more prevalent in adult-diagnosed asthma (89.2% versus 72.0%, p < 0.001). Risk factors of attacks of breathlessness during the last 12 months were adult-diagnosis (OR = 2.41, 95% CI 1.64-3.54, p < 0.001), female gender (OR = 1.49, 1.07-2.08, p = 0.018), family history of asthma (OR = 1.48, 1.07-2.04, p = 0.018) and allergic rhinitis (OR = 1.49, 1.07-2.09, p = 0.019). All the analysed asthma symptoms, except dyspnea in exercise, were more prevalent in adult-diagnosed asthma in age- and gender-adjusted analyses (p = 0.032-<0.001) which was also more often associated with 5 or more asthma symptoms (p < 0.001) and less often with non-symptomatic appearance (p < 0.001) than child-diagnosed asthma.

Conclusion: Responders with adult-diagnosed asthma had more often current asthma and a higher and multiform asthma symptom burden, although they used asthma medication more often compared to responders with child-diagnosed asthma.

Keywords: Age of onset; Asthma; Late-onset; Population study; Symptom.