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ASTHMA TREATMENTS

Although many people first develop asthma during childhood, asthma symptoms can occur at any time in life. This fact sheet provides general information about the nature of asthma when it appears in adults for the first time. We hope that the material helps you better understand what adult onset asthma is and how you can best manage it. Please keep in mind that this information is not meant to take the place of medical advice from your own physician.

What is adult onset asthma?

Asthma symptoms can appear at any time in life. People can develop asthma at age 50, 60, or even later. Adults who develop asthma are said to have adult onset asthma.

How does adult onset asthma compare with childhood asthma?

Unlike children who often experience intermittent asthma symptoms in response to allergy triggers or respiratory infections, adults with newly diagnosed asthma generally have persistent symptoms. Daily medications may be required to keep asthma under control.

Who gets adult onset asthma?

Several factors may make a person more likely to develop adult onset asthma. Women are more likely to develop asthma after age 20. Obesity appears to significantly increase the risk of developing asthma as an adult. Individuals who had asthma as a child may see asthma recur later in life.

What causes adults to develop asthma?

At least 30% of adult asthma cases are triggered by allergies. People who are allergic to cats may have an increased risk for developing adult onset asthma. Exposure to allergens or irritants such as cigarette smoke, chemicals, mold, dust, or other substances commonly found in the person’s environment (e.g. home or work place) might trigger the first asthma symptoms in an adult.

Prolonged exposure to certain workplace materials may set off asthma symptoms in adults.

Hormonal fluctuations in women may play a role in adult onset asthma. Some women first develop asthma symptoms during or after a pregnancy. Women going through menopause can develop asthma symptoms for the first time.

Can asthma reappear in adults after disappearing years ago?

Asthma is usually diagnosed in childhood. In many patients; however, the symptoms will disappear or are significantly reduced after puberty. After age 20, symptoms may begin to reappear.

Researchers have tracked this tendency for reappearing asthma and found that people with childhood asthma tend to experience reappearing symptoms through their 30s and 40s at various levels of severity.

Regardless of whether your asthma is active, you should continue to avoid your known triggers and keep your “rescue” medications or prescriptions up-to-date and handy in case you need them.

What are signs and symptoms of adult onset asthma?

Regardless of age, asthma symptoms can include:

• Dry cough, especially at night or in response to specific “triggers”

• Tightness or pressure in the chest

• Wheezing — a whistling sound — when exhaling

• Shortness of breath after exercise or physical exertion

• Difficulty breathing

• Colds that go to the chest or “hang on” for 10 days or more

How is the condition diagnosed?

To diagnose asthma, your physician will question you about your symptoms, perform a physical exam, and conduct lung function (breathing) tests. You also may be tested for allergies.

Your internist or family physician may refer you to an allergist or pulmonologist (who specializes in lung diseases) for specialized testing or treatment.

After middle age, most adults experience a decrease in their lung capacity. These changes in lung function may lead some physicians to overlook asthma as a possible diagnosis.

How can adult onset asthma be managed?

If you manage your asthma, you can expect to lead a normal lifestyle. Basically, there are four key steps to managing asthma successfully:

• Learn about asthma and stay up-to-date on new developments.

• Take prescribed medications. Don’t make any changes until you check with your physician. Don’t use over- the-counter medications unless prescribed by your physician!

• Check your lungs daily at home by using a peak flow meter. Asthma patients often can detect lung changes with a peak flow meter before they actually experience any changes. Visit your physician regularly for further in-office tests. Lung testing is painless and provides valuable data that helps your physician make adjustments in your medication.

What kind of physician treats adult onset asthma?

Many older patients are treated for asthma by their internist or family physician; however, if your asthma symptoms are not under control within three to six months, or if you have severe persistent asthma, or if you are having asthma episodes that need emergency treatment, it may be time to see an asthma specialist. Allergists/Immunologists or pulmonologists (who specialize in the treatment of lung diseases) are specialists who treat asthma. Those who have completed training in those specialties are usually called board-certified or board-eligible.

Does health insurance cover asthma treatment?

Most health insurance plans provide some level of coverage for asthma patients. Check with your insurance carrier for details. Some things you may want to find out might include:

• Do you need a referral to an asthma/allergy care specialist from your internist or family physician?

• Does the insurance carrier offer any patient education or specialized services related to asthma?

• If you had asthma when you were younger and are now experiencing adult onset asthma, does the insurance provider consider this a pre-existing condition? If so, what coverage is offered for pre- existing conditions?

• What medications are not covered by your plan? (There can sometimes be a delay in approving newly released medications. Your physician may know about them, but your insurance may not cover them yet.)

• Is a flu shot covered as part of asthma care? A pneumonia vaccine?