Impact of Cognitive Impairment and Depression on Asthma in Older Patients.

Depression and cognitive decline in older adults with asthma are associated with poorer disease control, increased risks for exacerbations, higher health care utilization, and greater mortality risk. In this age group, depression and cognitive impairment also negatively impact self-management behaviors and alter perception of asthma symptoms. Conversely, data suggest that in some individuals, asthma can induce depression and cognitive deficits, increasing the risk of dementia, including Alzheimer's disease. Because there is a bidirectional communication between the lungs and brain, asthma, particularly in the aged, may result in functional and structural changes of the central nervous system. Identifying and addressing depression and cognitive decline in older patients is often insufficiently integrated into clinical practice. Asthma in the aged is a distinctive phenotype and is complicated by increased risks for depression and loss of cognition, which collectively compromise management.