Increased blood eosinophils and airflow obstruction as new-onset asthma predictors in the elderly: The Nagahama study

  • Nishi Kenta
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine
  • Nagasaki Tadao
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine Department of Respiratory Medicine and Allergology, Kindai University Nara Hospital
  • Matsumoto Hisako
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine Department of Respiratory Medicine and Allergology, Kindai University Faculty of Medicine
  • Oguma Tsuyoshi
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine
  • Terada Satoru
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine
  • Nomura Natsuko
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine
  • Kogo Mariko
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine
  • Tashima Noriyuki
    Department of Respiratory Medicine, Kishiwada City Hospital
  • Sunadome Hironobu
    Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine
  • Murase Kimihiko
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine
  • Matsumoto Takeshi
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine Department of Respiratory Medicine, Saiseikai-Noe Hospital
  • Kawaguchi Takahisa
    Center for Genomic Medicine, Kyoto University Graduate School of Medicine
  • Tabara Yasuharu
    Center for Genomic Medicine, Kyoto University Graduate School of Medicine Graduate School of Public Health, Shizuoka Graduate University of Public Health
  • Matsuda Fumihiko
    Center for Genomic Medicine, Kyoto University Graduate School of Medicine
  • Sato Susumu
    Department of Respiratory Care and Sleep Control Medicine, Kyoto University Graduate School of Medicine
  • Chin Kazuo
    Center for Genomic Medicine, Kyoto University Graduate School of Medicine Department of Sleep Medicine and Respiratory Care, Division of Sleep Medicine, Nihon University School of Medicine
  • Hirai Toyohiro
    Department of Respiratory Medicine, Kyoto University Graduate School of Medicine

抄録

<p>Background: Asthma in the elderly needs more attention in an aging society. However, it is likely to remain underdiagnosed and undertreated. This study aimed to clarify clinical characteristics of new-onset asthma in the elderly, describing the prevalence, predictive factors, and comorbidities after asthma diagnosis of new-onset asthma in the elderly in the general population.</p><p>Methods: This community-based prospective cohort study enrolled 9804 generally healthy participants (30-74 years old) in Nagahama City, and conducted a follow-up assessment after 5 years. Elderly participants were those aged ≥65 years at baseline. Patients with new-onset asthma were defined as participants without asthma at baseline assessment and with asthma at the follow-up assessment.</p><p>Results: Among the 7948 participants analyzed in this study, 28 (1.4%) elderly and 130 (2.2%) non-elderly had new-onset asthma. Multiple logistic regression analysis revealed low forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and high blood eosinophil counts at baseline as predicting factors for new-onset asthma in the elderly. Additionally, subsequent incidence of new-onset asthma was higher in elderly participants with both predictors (high blood eosinophil counts and low FEV1/FVC at baseline) than those with none or one of the predictors before asthma diagnosis. Lastly, elderly patients with new-onset asthma had more frequent comorbidity of moderate to severe sleep disordered breathing than those non-elderly.</p><p>Conclusions: Eosinophilic inflammation and airflow obstruction may predict subsequent new-onset asthma after the age of 65 years. Revealing the characteristics of new-onset asthma in the elderly can aid in the prevention of underdiagnosed asthma.</p>

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