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Higher mortality rates among older adult asthma patients compared to their younger counterparts may be due, atleast in part, to an increase in airway inflammation, according toa study conducted by researchers in Canada, who note that theirresults imply that elderly patients are either less likely tofollow asthma medication dosing instructions, or that theunderlying airway inflammation in elderly patients is relativelyresistant to current anti-inflammatory therapies. The study was presented at the ATS 2012 International Conference inSan Francisco. "We found that asthmatic patients over the age of 65 have a higherproportion of airway inflammation when compared to youngerpatients, despite the fact that both groups received similar asthmatreatment regimens," said study lead author Richard Leigh, MD, PhD,associate professor of medicine at the University of Calgary. "Thefact that the majority of older patients were lifelong non-smokersindicates that asthma in the elderly is unlikely to be due tomisclassification of chronic obstructive pulmonary disease (COPD)." The Public Health Agency of Canada estimates that 7 percent ofpeople over 65 have asthma, a prevalence rate similar to thatreported in the United States. However, asthma-related mortalityrates in both countries are about tenfold higher in asthmatics over65 compared to any other age group. "The reasons for this difference are unknown and, in this study, wesought to test the hypothesis that airway inflammatorycharacteristics in older adults with asthma differ from other agegroups," said Dr. Leigh, who is also the GSK-CIHR Professor ofInflammatory Lung Disease at the University of Calgary. The researchers drew from information contained in the Universityof Calgary Asthma Clinic for 1,046 asthma patients, including 930patients under age 65 and 116 patients who were 65 or older,treated between April 2005 and June 2011. "Induced sputum cell counts are performed on all patients attendingour hospital-based outpatient asthma clinic to guide clinicalmanagement," Dr. Leigh said. "Patient data, including medications,spirometry measurements and sputum cell counts are entered into anelectronic database. These are the data we used for our study." Dr. Leigh and his colleagues performed a retrospective analysis todetermine the nature of the airway inflammation in patients whowere 65 or older, compared to those who were under age 65. Patients were divided into four inflammatory types, based on thetypes and numbers of leucocytes, or white blood cells, present inthe sputum: eosinophilic, neutrophilic, mixed granulocytic (botheosinophils and neutrophils) or pauci-granulocytic. Leucocytes are primary components of the human immune system,responding to sites of infection and inflammation; the presence ofleucocytes, and the numbers of cells present, can help cliniciansobjectively measure levels of airway inflammation. At the conclusion of their study, the researchers found that 75percent of older patients had higher than normal levels ofeosinophils in their sputum, while only 54 percent of youngerpatients had elevated eosinophil counts in their sputum samples. Inaddition, the median eosinophil count in the older group was 7percent compared to 2 percent in the younger group, indicatinghigher levels of inflammation in the older patients. Neutrophilcounts were not significantly different between older and youngerpatient groups. There were no differences in gender, body-massindex or treatment regimens between the two groups, and themajority (58 percent) of older patients were lifelong non-smokers.Older patients also had more severe airflow obstruction thanyounger patients. "The increased inflammation seen in older patients in this studymay help explain the reason why these patients tend to have worseclinical outcomes, including worse symptoms and lung function andincreased numbers of exacerbations, compared to younger patients,and may be a potential explanation for the increased mortality seenin these older folks," Dr. Leigh said. Dr. Leigh said the results also identify knowledge gaps andresearch opportunities that may ultimately lead to improvedtherapeutic approaches and healthcare outcomes in these patients. "We need to do additional studies to determine whether thisincreased inflammation in these older patients is due to either thefact that they don't take their medications, or that theinflammation is relatively resistant to asthma treatment in someway," he said. "To that end, we are now conducting a study to linkairway inflammation in patients older than 65 years of age to ratesof medication adherence." Additional References Citations. The e-commerce company in China offers quality products such as Waterproof LED Strip Lights Manufacturer , LED Brake Light Bulb Manufacturer, and more. For more , please visit Festoon LED Lights today!
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