Chest
Clinical InvestigationsAsthmaUnderdiagnosis and Undertreatment of Asthma in the Elderly
Section snippets
Recruitment
Participants in the CHS were selected using a Medicare eligibility list (United States citizens ≥ 65 years old) provided by the US Health Care Financing Administration for the four participating communities: Forsyth County, NC; Pittsburgh, PA; Sacramento County, CA; and Washington County, MD. These communities are diverse in proportion of minorities, education and income level, degree of urbanization, death rates, and availability of medical care. An age- and gender-stratified random sample of
Asthma Prevalence
A total of 4,581 participants were seen in the CHS clinics during the year 6 follow-up examination from May 1993 to June 1994. Four percent of all CHS participants reported current (definite) asthma that had been confirmed by a physician (Table 1). An additional 4% reported at least one attack of wheezing with dyspnea or chest tightness during the previous year (probable asthma), and an additional 11% reported wheezing brought on by various exposures (possible asthma). Not included in the
Asthma Prevalence
The CHS is one of the largest population-based examinations of heart and lung disease in elderly persons in the United States. The 6% prevalence of a history of asthma at the CHS baseline examination and 4% prevalence of current asthma during this follow-up examination are similar to the rates reported in subjects > 65 years of age during a postal survey in northern Sweden18 and in Australia.19
The correlates of major respiratory symptoms and obstructive lung diseases in the CHS cohort at the
Participating Institutions and Principal Staff
Forsyth County, NC—Bowman Gray School of Medicine of Wake Forest University: Gregory L. Burke, Alan Elster, Walter H. Ettinger, Curt D. Furberg, Edward Haponik, Gerardo Heiss, Dalane Kitzman, H. Sidney Klopfenstein, Margie Lamb, David S. Lefkowitz, Mary F. Lyles, Maurice B. Mittelmark, Cathy Nunn, Ward Riley, Grethe S. Tell, James F. Toole, and Beverly Tucker; ECG Reading Center—Forsyth County, NC—Bowman Gray School of Medicine: Kris Calhoun, Harry Calhoun, Farida Rautaharju, Pentti Rautaharju,
Classification of Asthma Severity†
Severe Persistent Asthma (GIA Step 4)
- 1.
Continuous symptoms: “Do you have trouble with your breathing continuously?” = yes
- 2.
Frequent nighttime symptoms: “How frequently have you had these symptoms (chest tightness or breathlessness with wheezing)?” = at least every day or night
- 3.
Light physical activities limited by asthma symptoms: “Do you get short of breath with light physical activity, such as… ?” = yes, and “How short of breath do you feel during this activity?” = very or extremely
- 4.
FEV1 < 50%
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Supported by National Heart, Lung, and Blood Institute contract N01–87079.
- †
A complete list of participants is located in Appendix 1.