People over 65 are more likely to have asthma than other age groups. At the same time research shows older people with asthma are more likely to be undertreated and hospitalised. This age group is also more likely to miss out on an accurate asthma diagnosis.
“If you’ve had asthma for a long time, it’s important to check in with how well you’re managing your asthma in your later years,” says Dr Andy Whittamore, Asthma UK’s in-house GP. “And if you haven’t had asthma before, stay alert to any new symptoms, like coughing or breathlessness, that could be a sign of it.”
If you’re getting breathless, see your GP or asthma nurse as soon as possible to lower your risk of a life-threatening asthma attack.
Feeling breathless could be a sign that:
You have undiagnosed asthma
Many older people don’t get their asthma diagnosed because they think their symptoms, such as being short of breath, are just part of getting older. It’s important to realise this isn’t always the case.
Your asthma’s getting worse
Tell your GP or asthma nurse about any new symptoms you notice, including breathlessness. They may need to change your medicines or doses so you stay well with your asthma.
You have another health condition
There are lots of reasons why you can get breathless. As well as asthma, breathlessness can be a sign of pneumonia, heart disease, obesity, chronic obstructive pulmonary disease (COPD) and panic attacks.
“If you’re getting breathless, your GP or asthma nurse may ask you to do a lung function test. This shows how well you can fill your lungs with air, and how well you can breathe out again,” says Dr Andy Whittamore.
“It's normal for the results of this test to go down as you get older and nothing to worry about. But if you've noticed you're more breathless when you’re walking upstairs or up a hill, for example, see your GP to get it checked out.”
Changing asthma symptoms
Even if you’ve had the same or similar symptoms for years, your asthma may change over time as you get older.
You may notice:
- fewer asthma symptoms
- more asthma symptoms
- some asthma symptoms that are more obvious than they were before
- your medicines aren’t working as well
- side effects of your asthma medicines seem worse
- new things trigger your asthma
If you spot any of these changes, it’s a good idea to keep a symptom diary so that you can take it to an appointment with your GP or asthma nurse and show them exactly what’s changed.
They can talk to you about ways to avoid your individual triggers, and look at any lifestyle factors that could be affecting your asthma. It may be that you now need to make some small changes to stay well with your asthma. Your GP or asthma nurse may also change your medicines or doses.
How your healthcare team can support you
Managing your asthma may become more challenging in later life. This might be because your symptoms have got worse. It could also be because you need to manage your asthma alongside treatments for other conditions, such as diabetes or heart disease.
Your GP, asthma nurse, or consultant can help you manage your asthma to help prevent symptoms and cut your risk of a potentially life-threatening asthma attack.
Keep going to your regular asthma review, and book any extra appointments when you need them.
Your inhaler technique
To make the most of your asthma medicines, you need to take your inhaler(s) in the right way. Ask your GP or asthma nurse to check your inhaler technique – even if you’ve been using an inhaler for years it’s worth making sure you haven’t slipped into bad habits without realising.
And if you're finding it difficult to use your inhaler correctly - for example, if another condition, such as arthritis, affects your hands and fingers - ask your GP or asthma nurse for advice. There’s a wide range of inhalers available and you may find it easier to try a different type.
Your asthma medicines
Your medicines may need to work harder as you get older, so it’s a good idea to see your GP or asthma nurse for an asthma review at least once a year so you can check that the medicines you’re taking are the right ones for you and that you’re using them correctly. The best treatment plan for you now might be different to the one you had when you were younger.
Your asthma action plan
A written asthma action plan can help you to stay well with your asthma, and to manage your medicines and triggers. It can also help remind you what to do if you have an asthma attack.
You and your GP or asthma nurse can make sure you have an up to date action plan. Download one now and take it to your next asthma review.
Possible side effects from your asthma medicines
For some people, some of the side effects of asthma medicines, such as an increased heart rate or feeling shaky after using their reliever inhaler, feel worse now they're older.
For others, long-term use of oral steroids (prednisolone tablets) and high doses of inhaled steroids (in some preventer and combination inhalers) can increase the risk of developing cataracts, osteoporosis, and thinner skin that bruises easily. Not everyone will experience these side effects.
Your GP, asthma nurse or consultant can talk to you about:
- any worries you have about your asthma medicines
- how likely you are to be at risk of side effects
- what you can do to help prevent and reduce any side effects
It’s important to keep taking your asthma medicines, but talk to your GP or asthma nurse as soon as possible if you’re worried about any side effects.
Regular asthma reviews (at least once a year) will also give your GP or asthma nurse a chance to change your medicines so you’re taking the lowest possible dose to keep well.
Manage your asthma triggers
Some older people find they’re sensitive to things they’ve been around for years that weren’t a problem before, or to completely new things. Changes, such as retiring to a new area or moving house, can expose you to new triggers.
You might be more at risk of lung infections or take longer to recover if you get a viral infection. As well as reading up about all the things you can do to ward off colds and flu, speak to your GP or asthma nurse about whether you need the flu vaccine every year and/or a one-off pneumococcal vaccine to protect against pneumonia.
Keep well with your asthma in later life
There are lots of things you can do to help you stay well with your asthma in later life. For example:
- Stay active - studies have shown that people who keep exercising as they get older stay healthier than people who don't.
- Keep to a healthy weight - research has found that overweight people with asthma who lose weight have fewer asthma symptoms.
- Stop smoking - evidence shows stopping smoking means you won’t get as many asthma symptoms and that your medicines will be more effective.
- Look after your mental health - stress, anxiety and depression can make your asthma worse because they can be a trigger for some people, so if you’re worried, down or lonely, talk to someone about how you feel. You can talk to your GP or asthma nurse. Or call one of the asthma nurse specialists on our Helpline: 0300 222 5800 (9am - 5pm; Mon - Fri)
There is evidence that asthma is often underdiagnosed in older adults – sometimes because people don’t tell their doctor about their symptoms and sometimes because it gets misdiagnosed as a different condition.
So even if you haven’t ever had asthma symptoms before, it’s important to tell your GP as soon as possible if you are experiencing any of the following:
You don’t need to have all these symptoms to have asthma.
It’s also useful to remember that:
- Many people aged 65 and older get their first asthma symptoms after an upper respiratory (chest) infection.
- People who get asthma later in life sometimes experience a more serious form of asthma.
- In people who are 65 and older, asthma affects more women than men.
- Inducible laryngeal obstruction, where the vocal cords don't open properly, shares symptoms with asthma, which can make asthma harder to diagnose. And some other conditions like obstructive sleep apnoea and acid reflux can make asthma symptoms worse.
Last reviewed May 2019
Next review due May 2022