Asthma manifests itself differently in children, adults and elderly people. In children, it is usually manifested as cough and wheeze; in adults, as paroxysmal attacks of breathlessness; in older people, while paroxysmal attacks may continue, exertional dyspnoea (breathlessness on exertion) also set in due to the complications of chronic bronchitis and emphysema. While adult asthma patients feel normal in between the attacks, older patients continue getting breathlessness on exertion even while they do not have the asthma attack.
Those who first start getting asthma in their old age, fare far worse than those who have had the onset in their youth.
Treatment
Treatment of asthma in older patients needs much more attention and care. Male patients having enlarged prostate gland face a particular difficulty; administration of bronchodilators containing ephedrine may lead to hesitancy in passing urine or lead to the retention of urine.
Corticosteroids can lead to softening of bone (osteoporosis) and the facture of already fragile bones. Some older patients who had been taking corticosteroids for a long time are known to have fractured their ribs on coughing. The incidence of tuberculosis is also appearable in those who take corticosteroids; symptoms of such a condition may not become clear till much later.
Injection of adrenaline in status asthmaticus endangers the heart and blood vessels of those who have hypertensive heart disease.
In older people, it is not easy to differentiate whether it is certainly a case of asthma because cough and breathlessness in this age-group are symptoms of many other diseases also.
