Research Article| Volume 86, ISSUE 1, P27-32, January 1992

Respiratory symptoms as predictors of airways lability in anelderly population

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      In an attempt to identify patterns of symptoms which might predict treatable airways obstruction in the elderly, we measured respiratory function and airways lability in 296 men and women aged 65 and over. Subjects were selected to represent eight symptom groups as ascertained in a postal survey of patients randomly selected from three general practice lists. Airways obstruction was strongly associated with smoking, but bronchial hyperresponsiveness to methacholine and reversibility of airways obstruction with salbutamol (measured when hyperresponsiveness could not be assessed) were not. There was evidence of bronchial hyperresponsiveness or salbutamol reversibility in 37% of symptomatic non-smokers. This points to a substantial component of obstructive lung disease in the elderly that is characterized by labile airways and unrelated to smoking. Symptoms of the ‘bronchial irritability syndrome’ were more strongly associated with airways lability than other symptoms, but their predictive value for airways lability (32%) was much lower than has been reported in younger adults.
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        • Banerjee DK
        • Lee GS
        • Malik SK
        • Daly S
        Underdiagnosis of asthma in the elderly.
        BrJ Dis Chest. 1987; 81: 23-29
        • Burrows B
        • Lebowitz MD
        • Barbee RA
        Respiratory disorders and allergy skin reactions.
        Ann Intern Med. 1976; 84: 134-139
        • Cookson WO
        • Musk AW
        • Ryan G
        Association between asthma history, atopy and non-specific bronchial responsiveness in young adults.
        Clin Allergy. 1986; 16: 425-432
        • Woolcock AJ
        • Peat JK
        • Salome CM
        • et al.
        Prevalence of bronchial responsiveness and asthma in a rural population.
        Thorax. 1987; 42: 361-368
        • Cockcroft DW
        • Killian DN
        • Mellon JJA
        • Hargreave FE
        Bronchial reactivity to inhaled histamine: a method and clinical survey.
        Clin Allergy. 1977; 7: 235-243
        • Juniper EF
        • Frith PA
        • Hargreave FE
        Airway responsiveness to histamine and methacholine: relationship to minimum treatment to control symptoms of asthma.
        Thorax. 1981; 36: 575-579
        • Mortagy AK
        • Howell JBL
        • Waters WE
        Respiratory symptoms and bronchial reactivity: identification of a syndrome and its relation to asthma.
        BrMed J. 1986; 293: 525-529
        • Dow L
        • Coggon D
        • Osmond C
        • Holgate ST
        A population survey of respiratory symptoms in the elderly.
        Eur Resp J. 1991; 4: 267-272
        • Burr ML
        • Phillips KM
        • Hurst DN
        Lung function in the elderly.
        Thorax. 1985; 40: 54-59
        • Yan K
        • Salome C
        • Woolcock AJ
        Rapid method for measurement of bronchial responsiveness.
        Thorax. 1983; 38: 760-765
        • Josephs LK
        • Gregg I
        • Mullee MA
        • Holgate ST
        Nonspecific bronchial reactivity and its relationship to the clinical expression of asthma. A longitudinal study.
        AmRev Respir Dis. 1989; 140: 350-357
        • McCullagh P
        • Nelder J
        Generalised Linear Models.
        Chapman and Hall, London1989
        • Britton J
        • Mortagy A
        • Tattersfield AE
        Histamine challenge test: comparison of three methods.
        Thorax. 1986; 41: 128-132
        • Schmidt O
        • Dickman ML
        • Gardner RM
        • Brough FK
        Spirometric standards for healthy men and women: 532 subjects ages 55 through 94 years.
        AmRev Respir Dis. 1973; 108: 933-939
        • Clifford RD
        • Radford M
        • Howell JB
        • Holgate ST
        Prevalence of atopy and range of bronchial response to methacholine in 7 and 11 year old schoolchildren.
        Arch Dis Childhood. 1989; 64: 1126-1132
        • Burney PGJ
        • Britton JR
        • Chinn S
        • et al.
        Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study.
        Thorax. 1987; 42: 38-44
        • Lorber DB
        • Kaltenborn W
        • Burrows B
        Response to isoproterenol in a general population sample.
        AmRev Respir Dis. 1978; 118: 855-861
        • Fletcher C
        • Peto R
        • Tinker C
        • Speizer FE
        The Natural History of Chronic Bronchitis and Emphysema.
        Oxford University Press, Oxford1976
        • Cockcroft DW
        • Berscheid BA
        • Murdock KY
        Bronchial response to inhaled histamine in asymptomatic young smokers.
        Eur J Respir Dis. 1983; 64: 207-211
        • Brown NE
        • McFadden ER
        • Ingram RH
        Airway responses to inhaled histamine in asymptomatic smokers and non-smokers.
        J.Appl Physiol. 1977; 42: 508-513
        • Gerrard JW
        • Cockcroft DW
        • Mink JT
        • Cotton DJ
        • Poonawala R
        • Dosman JA
        Increased non-specific bronchial reactivity in cigarette smokers with normal lung function.
        AmRev Respir Dis. 1980; 122: 577-581
        • Taylor RG
        • Clarke SW
        Bronchial reactivity to histamine in young male smokers.
        Eur J Respir Dis. 1985; 66: 320-326
        • Cerveri I
        • Bruschi C
        • Zoia MC
        • et al.
        Smoking habit and bronchial reactivity in normal subjects. A population based study.
        AmRev Respir Dis. 1989; 140: 191-196
        • Newell-Price R
        • Clough J
        • Dow L
        • Holgate ST
        The relation between non-specific bronchial hyperrespon-siveness and the bronchodilation produced by inhalation of salbutamol.
        Thorax. 1989; 44 (Abstract): 868P