Respiratory investigation · 2026
Decline in physical function and baseline depressive symptoms are associated with worsening asthma outcomes in older adults: A 12-month prospective cohort study.
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Maeda Akiko, Tobino Kazunori, Harada Norihiro, Takahashi Kazuhisa
Аннотация
BACKGROUND: Comprehensive geriatric assessment (CGA) may identify non-pulmonary vulnerabilities that influence asthma outcomes in older adults; however, longitudinal associations with clinical outcomes remain unclear. We investigated associations between CGA parameters and respiratory outcomes in older adults with asthma.
METHODS: This 12-month prospective cohort study included 36 community-dwelling adults with asthma aged ≥65 years who completed the 12-month follow-up. Asthma control (Asthma Control Test [ACT] and Asthma Control Questionnaire-6 [ACQ-6]), lung function (forced expiratory volume in 1 s [FEV1] and percent-predicted FEV1), biomarkers (fractional exhaled nitric oxide [FeNO] and peripheral blood eosinophil count), and CGA domains (Barthel Index, Instrumental Activities of Daily Living [IADL], Mini-Mental State Examination [MMSE], and Geriatric Depression Scale-15 [GDS-15]) were assessed at baseline and 12 months. Change scores (Δ) were defined as 12-month minus baseline values. Associations between ΔCGA domains and Δclinical outcomes were examined using Spearman's rank correlation.
RESULTS: A 12-month change in basic activities of daily living (ΔBarthel Index) was significantly correlated with a concurrent change in asthma control (ΔACT; ρ = 0.42, P = 0.01). A ΔGDS-15 was significantly correlated with ΔFEV1 percent predicted (ρ = 0.53, P < 0.01). In addition, ΔIADL was significantly correlated with a change in peripheral blood eosinophil count (ρ = 0.42, P = 0.01).
CONCLUSIONS: In older adults with asthma, longitudinal changes in functional status and mood were associated with contemporaneous changes in asthma control and lung function, and changes in IADL were associated with changes in eosinophil counts. These findings support the potential value of incorporating brief geriatric screening into routine asthma care to help contextualize asthma trajectories in older adults; confirmation in larger cohorts is warranted.
METHODS: This 12-month prospective cohort study included 36 community-dwelling adults with asthma aged ≥65 years who completed the 12-month follow-up. Asthma control (Asthma Control Test [ACT] and Asthma Control Questionnaire-6 [ACQ-6]), lung function (forced expiratory volume in 1 s [FEV1] and percent-predicted FEV1), biomarkers (fractional exhaled nitric oxide [FeNO] and peripheral blood eosinophil count), and CGA domains (Barthel Index, Instrumental Activities of Daily Living [IADL], Mini-Mental State Examination [MMSE], and Geriatric Depression Scale-15 [GDS-15]) were assessed at baseline and 12 months. Change scores (Δ) were defined as 12-month minus baseline values. Associations between ΔCGA domains and Δclinical outcomes were examined using Spearman's rank correlation.
RESULTS: A 12-month change in basic activities of daily living (ΔBarthel Index) was significantly correlated with a concurrent change in asthma control (ΔACT; ρ = 0.42, P = 0.01). A ΔGDS-15 was significantly correlated with ΔFEV1 percent predicted (ρ = 0.53, P < 0.01). In addition, ΔIADL was significantly correlated with a change in peripheral blood eosinophil count (ρ = 0.42, P = 0.01).
CONCLUSIONS: In older adults with asthma, longitudinal changes in functional status and mood were associated with contemporaneous changes in asthma control and lung function, and changes in IADL were associated with changes in eosinophil counts. These findings support the potential value of incorporating brief geriatric screening into routine asthma care to help contextualize asthma trajectories in older adults; confirmation in larger cohorts is warranted.