People may tend to think of asthma as a concern for children, but people over age 65 can also develop the condition. In fact, the Centers for Disease Control and Prevention (CDC) reports that in 2017 (the most recent year for which statistics are available), nearly than 3.5 million Americans age 65 and older had asthma.
Because people older than age 65 are likely to have other health problems and more frequent symptoms if they develop asthma, finding the appropriate treatment is particularly important in this age group. Without proper management and prompt treatment of asthma attacks, the disease can be life-threatening.
The onset of an asthma attack may be gradual or sudden, and most attacks require medication to resolve. Milder attacks are most common and usually begin with tightness in the chest and a cough. Breathing may be accompanied by wheezing as well as by restlessness and difficulty sleeping. Sometimes mild attacks seem to improve for a while, only to be followed by the reappearance of persistent symptoms that require treatment in a hospital. During a severe asthma attack, extreme shortness of breath is accompanied by wheezing, tightness in the chest, coughing up thick phlegm, sweating, faster breathing, and a rapid pulse. Symptoms may last for only a few minutes, particularly if they are treated promptly, or they may last for hours or days, even with medication. Coughing can continue for a week or longer after other acute symptoms disappear.
Diagnosis during an asthma attack is usually obvious from the symptoms, especially in someone with a history of asthma. But with older people, it is easy for doctors to mistake asthma for conditions such as chronic obstructive pulmonary disease (COPD), heart failure, or a heart attack. In heart failure, fluid may accumulate in the lungs, causing some of the same signs and symptoms as asthma. In adults, the diagnosis of asthma requires pulmonary function tests to measure airway obstruction, an examination of mucus from the nose and lungs, or allergy tests.