Asthma in the elderly.

Fifteen patients who developed asthma after the age of 60 years are reported. Attention is drawn to apparent difficulties of diagnosis in this age group. A history of chronic bronchitis is common, and a change in symptoms, especially the abrupt onset of increased breathlessness, wheezing, and paroxysmal nocturnal dyspnoea, should arouse suspicion of the development of asthma. A past or family history of allergy is confirmatory evidence, as is the presence of blood or sputum eosinophilia. Retrosternal pain is not uncommon, and angina pectoris or left ventricular failure must be excluded. Chest radiographs showed changes consistent with old quiescent tuberculosis in five patients; careful follow-up is therefore essential as asthma in this age group often requires steroid therapy.