Age at onset presents opportunity to improve asthma management

Researchers have shown that age at diagnosis of asthma may influence future outcomes and level of symptom control.

In particular, the findings highlight that patients with asthma onset between the ages of 5 and 9 years have better symptom control than those with onset earlier in childhood, which the authors suggest may be due to them managing their own condition from early on.

“If the age at asthma onset affects the manner in which a patient learns how to manage and treat symptoms of asthma, then our findings reveal opportunities to examine how this knowledge may be used to improve asthma management and subsequent respiratory health outcomes,” say Maria Mirabelli (Centers for Disease Control and Prevention, Atlanta, Georgia, USA).

The team used data from the Behavioral Risk Factor Surveillance System Asthma Call-back Survey on 12,216 adults with active asthma.

Among the 42% of respondents in whom asthma began before the age of 16 years, those diagnosed between the ages of 5 and 9 years had the lowest mean percentage of symptoms in the past 30 days (21%), and symptoms that kept them awake at night (8%).

By contrast, for patients whose asthma began within the first year of life, the rate of recent symptoms was 14.8% higher, and the rate of symptoms disturbing sleep was 8.1% higher than those diagnosed aged 5 to 9 years.

The prevalence of asthma attacks, emergency hospital visits, and hospital admission in the past 12 months notably declined with increasing age at diagnosis in those diagnosed before the age of 10 years; in older patients, the authors did not observe much change in the need for emergency or inpatient hospital care according to age at onset. Patients aged 50 years or older at onset had the lowest incidence of asthma attacks in the past 12 months relative to those whose onset occurred at ages 5 to 9 years.

Writing in Respiratory Medicine, Mirabelli et al suggest that as children diagnosed with asthma at a very young age probably had their condition primarily managed by their parents, they may not have developed the same self-management skills of children diagnosed at a later age.

“Our findings reveal opportunities for further investigation of the role of age at asthma onset in determining behaviors, such as using medication, recognizing and avoiding symptom triggers, or communicating with health care personnel, which may influence respiratory health outcomes,” they conclude.

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