Asthma in the older generation: increased challenges

Older adults with asthma face extra challenges including multiple illnesses, medications and ageism from healthcare providers, study finds

Asthma is often underdiagnosed, undertreated and poorly self-managed by older adults: the UK’s fastest growing population. A recent publication in the journal ‘Aging and Health Research’ aimed to explore the perceptions of older adults with asthma in the UK and how it affects their life. The researchers wanted to identify areas of research that could improve their quality of life.

In keeping with the ethos of the Centre, this study was co-produced by Centre former Patient and Public Involvement Patient Lead, Elisabeth Ehrlich. The study was her idea and she and other PPI members were involved throughout, participating in pilot interviews, providing feedback, and reviewing, defining and finalising the themes from the interviews. Elisabeth is also a co-author on the publication.

The study

This qualitative study involved interviewing 16 adults over 60 living with asthma in the UK, and found multiple themes from the discussions.

Impact of asthma on daily living

Participants described asthma as “tiring”, and that growing older with asthma increased this feeling. They felt a reduction in their social connections due to their condition, and lived in fear of having an asthma attack.

Managing asthma

The participants felt a routine was important for helping them manage their asthma. However, at times taking medication became so routine that it was sometimes difficult to remember whether it had been taken. Electronic reminders were mentioned as useful reminders to take medication, but it was recognised that technology may not be suitable for all older adults.

Asthma and other conditions

An aspect of the older generation that should be considered is how treatments, medications and symptoms of different conditions combine to make living with asthma even more difficult. All but one of the participants were living with multiple conditions. At times, optimum treatment for other conditions were not offered because the participants had asthma.

Interaction with healthcare

The participants felt that healthcare professionals were dismissive and disinterested in their asthma, and that there was a lack of understanding of the condition. The older adults mentioned that they were a burden to the healthcare system because of their age and the combination of other conditions alongside their asthma. Ageism was experienced by all participants.

Understanding of asthma

Since the participants had been living with asthma for a long time, they had first-hand experience of how living with asthma looked for them. They want more opportunities to share their thoughts on how their asthma is managed when discussing with their healthcare professional. However, many participants found that the power balance was typically not in their favour and their personal experience was often dismissed. They perceived that healthcare professionals think of asthma as a disease of childhood, and that there was a lack of awareness and understanding of asthma in older adults. Additionally, all participants welcomed future asthma research which is more inclusive to all ages, and the unique challenges of living with asthma as an older adult should be further explored.

COVID-19

Since the study was conducted at the outbreak of the COVID-19 pandemic, participants were concerned about the potential risk of serious illness, due to their ages, having asthma and other conditions which made them vulnerable. They also worried about the psychological impact on their families who could pass COVID-19 on to them.

Calls for change

This study was one of the first to explore the experiences of older adults living with asthma in the UK, and how it affects their lives. The conclusions are that the lack of understanding, awareness and coverage of asthma in older adults led to participants feeling forgotten.

The authors suggest future research into the development of:

• Accessible medication devices
• Greater understanding in healthcare to improve patient relationships with their healthcare professionals
• Clinical trials to ensure treatments are effective for older adults with asthma

Dr Tracy Jackson, Co-Lead for Patient and Public Involvement at the Centre and lead author on the study, believes this study could open doors for future research. She said:

Older adults with asthma deserve the same levels of research that go into childhood asthma. This study has helped us understand some of the daily concerns for older people living with asthma. Future research could help us make sure they feel seen and heard when approaching their healthcare professional about their asthma.

Elisabeth Ehrlich, former volunteer Patient and Public Involvement Lead was the key driver behind this study. She said:

Feeling heard as a patient is essential. This study goes some way to give an understanding of the experience of being an older adult with asthma. I hope it is the start of more research for older people with asthma so treatments, management and medications can be tailored to this group.

Read the paper

This publication is available from Aging and Health Research

Cite as

Tracy Jackson, Flora Flinn, Lewis Rafferty, Elisabeth Ehrlich, Monica Fletcher, Exploring the experiences of older adults living with asthma in the United Kingdom: A co-produced qualitative study, Aging and Health Research, Volume 2, Issue 2, 2022, 100079, ISSN 2667-0321, https://doi.org/10.1016/j.ahr.2022.100079.

More about this study

Read more about the Exploring the experiences of older adults living with asthma project