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Having Asthma as an Older Adult

Watch out for these special concerns if you're over 50.

Having Asthma as an Older Adult

Think asthma strikes only the young? Not so—a whopping 18.7 million adults live with the condition in the US alone. In fact, adult-onset asthma can occur at any time in life—even in adults over 50.

There are two reasons older adults get diagnosed with asthma for the first time, says Stephen Wasserman, MD, professor of medicine in the division of Rheumatology, Allergy & Immunology at UCSD. First, many adults have had symptoms their whole life, and they're only just getting diagnosed in older age. For example, they may have lived with a chronic cough and thought it normal until their diagnosis.

Or, asthma symptoms are sometimes triggered after a specific health problem, such as viral pneumonia. Dr. Wasserman also noted that childhood asthma sometimes comes back as you get older. No one knows why, but some people seem to go through a "honeymoon period" when they don't have symptoms, only to have asthma reappear later in life.

Will asthma change as you get older?
While symptoms in children and teens usually come and go, adults tend to have more persistent symptoms. Also, people with adult-onset asthma usually don't "outgrow" it, the way some children do.

But the real problem with asthma as you get older isn't really about asthma itself. "The biggest issue with aging asthmatics is the risk of developing other conditions," Wasserman explains. "Having multiple illnesses at once can exacerbate asthma symptoms."

That means if you're managing more than one health problem, you may need to check in with your asthma doctor more often to make sure that other medicine you take isn't making asthma worse. He said most medications can work together without a problem. For example, most people are able to use inhaled medications for asthma even if they have other health concerns. But they should be used with caution if you're also taking medicine for a GI condition or heart disease.

Wasserman recommends seeing a general doctor, an allergist and other specialists (such as a cardiologist for a heart problem), so that, together as a team, you can keep your asthma and health on track.

Warning signs that asthma is getting worse
If you've had asthma your whole life (whether you knew it or not) that's gone untreated, it will undoubtedly get worse over time. The good news is that if you've been managing asthma successfully for years, you know your symptoms, triggers and best meds.

As a reminder, here are some signs asthma may be worsening:

  • Your symptoms are flaring frequently (more than twice a week or even daily)
  • You're having trouble sleeping
  • You're cutting back on more and more activities
  • Symptoms are more severe than usual

If you feel like your treatment isn't working, circle back with your doctor to tweak your asthma action plan for better results.

But a word to the wise from Wasserman: Feeling asthma relief doesn't necessarily mean you should stop taking your control medication. Asthma meds only treat symptoms—not cure the disease, he says. "So if someone isn't seeing symptoms, that means the controller meds are working really well, and you don't want to halt effective treatment." 

Medically reviewed in April 2018. Updated in August 2019.

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