Asthma and the Older Australian: What we know and what we need to do

New asthma research indicates that as many as a third of people +55 years old may be living with undiagnosed asthma and that a high prevalence of asthma in an ageing population will impose an increasing burden on the health system and the Australian economy in the future.

Titled: "Asthma and the Older Australian: What we know and what we need to do," the 13 research papers, published as a supplement to the Medical Journal of Australia on 4th July, are the result of a successful Macquarie Bank Asthma Australia Research Colloquium hosted by the Asthma Foundations in partnership with the Macquarie Bank Foundation in October last year.

The papers provide an alarming insight into asthma among older Australians.

• Despite the fact that older people account for 61 per cent of all asthma deaths each year, most asthma research is currently focused on younger age groups.
• A South Australian study found that 33 per cent of people in its over 55 age sample group had asthma but had not been diagnosed. Ten per cent of those had medium to severe symptoms and experienced a much poorer quality of life.
• Due to other complicating medical conditions and the complex nature of asthma itself, asthma is harder to diagnose in older people and is significantly under-diagnosed by doctors.
• An overview of asthma in older people established that there is no specific asthma management plan in place for older people.
• A study conducted in Busselton, West Australia, concluded that the incidence of asthma tripled between 1966 and 1994 in all age groups.

"Much of what we now know and do for asthma in older people is based on studies conducted in young people with asthma, and these findings may be of limited relevance," said Colloquium co-chair and respiratory expert Professor Peter Gibson.

"These papers highlighted the need to better understand how the lung ages, the nature of airway disease in older people, the impact of age and co-morbidity in asthma, and the need to improve diagnosis of asthma in older people," said Professor Gibson.

More worrying is the growing number of older people that have asthma in the +55 age range and the possible future impact of asthma in an ageing population.

Australia currently has the third highest incidence of asthma in the world with 10 per cent or 2.2 million Australians living with asthma. If the latest world projections are correct that number could increase by 25 per cent by 2050. It is estimated that asthma already costs the Australian economy $500 to $750 million per year.

"Urgent steps are needed to remedy the current situation and arrest a continued increase in asthma in older people that could have serious social, medical and economic implications," said President of the Asthma Foundations of Australia, Peter Adamson.

"Government Ministers have recognised that Australia does have an ageing population and to maintain a viable tax base people need to keep working to 65 and beyond. A rising prevalence of asthma in an ageing population may affect people's ability and desire to contribute fully, not to mention the extra burden it would mean on medical and social services," said Mr Adamson.

It was such concerns that encouraged the Macquarie Bank Foundation to commit $1 million to asthma research over five years.

"The partnership between the Asthma Foundations and the Macquarie Bank Foundation has resulted in several initiatives, including a national asthma research fund, a national website, PhD scholarships and a biennial research Colloquium," said David Clarke, Executive Chairman of the Macquarie Bank Foundation.

"Importantly, the Colloquium brought together researchers and other experts to share their knowledge on a particular aspect of asthma and set a course for future research," said Mr Clarke.

The Colloquium found that the key objectives of future programs and service delivery for older Australians should be to:

• increase the awareness and understanding of asthma in older Australians and their families;
• improve accuracy of diagnosis of asthma in the older population in the general practice setting
• increase provision of specific tailored asthma management and care for the elderly
• build the capacity and confidence of older people with asthma to self manage their chronic illness.

"The Colloquium highlighted the current gaps in asthma information, management and service provision targeted specifically to the needs of older Australians. Targeted services and programs need to be developed and implemented for this age group that incorporate both chronic illness management models and health promotion approaches," said Mr Adamson.

"In response, the Asthma Foundation is now developing a three year Asthma and Older Australians program, which will address some of these issues and be commended to the Government funding as a national health initiative.

"I also commend and look forward to the future plans of the 'Healthy Airways, Healthy Ageing' working party which was formed to further the work started at the Colloquium and continue the commitment of all participants to improving the health and wellbeing of older Australians with asthma," Mr Adamson concluded.