Multiple Logistic Regression Analysis of Risk Factors for the Development of Steroid-Dependent Asthma in the Elderly: A Comparison with Younger Asthmatics

Abstract

Background: The percentage of the aged among all patients with bronchial asthma is increasing. Objective: To investigate the risk factors for the development of steroid-dependent asthma in the elderly. Methods: A multiple logistic regression analysis involving various clinical factors between steroid-dependent and -independent asthma was carried out for 59 asthmatics aged over 60 years, including 16 patients with steroid-dependent asthma. The calculated risk for each factor was compared with that obtained from 122 younger asthmatics aged 20–59 years. Results: Among the factors examined (sex, age, period from onset of asthma, type of asthma and family history of asthma, plus history of smoking, atopic dermatitis, allergic rhinitis, chronic sinusitis and nasal polyps), the significant risk factors for the development of steroid dependency in the elderly asthmatics were only family history of bronchial asthma (relative risk 3.6) and smoking history (relative risk 6.9). Conclusions: Some risk factors for steroid-dependent asthma in younger individuals were not significant in the elderly. Since the smoking history was most closely associated with the development of steroid dependency in the elderly, even though most of them had quit smoking, it is important for patients with asthma to avoid smoking.

Evaluation of the Role of Interleukein-2 and Interleukein-4 in the Immunopathogenesis of Steroid Therapy Resistance in Iraqi Asthmatic Patients

“…The present study showed that the incidence of steroid resistance is increased among all patients' age rang. This is come in agreement with that reported by Ishioka and his co-workers (30) . However, resistance to steroid did not significantly affected by sex variation, but may be linked to other factors such as smoking habit and presence of atopic allergy, a finding supported by what reported by others (31,32) .…”

Nasal polyps and the severity of asthma

“…The NP incidence in asthma patients is 4-32%, but in the presence of asthma with analgesic intolerance, the incidence increases to 48-95%. [24][25][26] In the present study, only incomplete data could be In asthma patients, the presence of NP appears to be a risk factor for increased severity of asthma. 27 The incidence of NP in severe asthma patients is high.…”

“…Of adult asthma patients, 3–21% have analgesic intolerance. The NP incidence in asthma patients is 4–32%, but in the presence of asthma with analgesic intolerance, the incidence increases to 48–95% 24–26 . In the present study, only incomplete data could be obtained from patients regarding their analgesic intolerance.…”

Causative and Contributive Factors to Asthma Severity and Patterns of Medication Use in Patients Seeking Specialized Asthma Care *

“…The relationship between chronic sinusitis and severe asthma has been previously studied, but the results have been conflicting. For instance, in a study by Ishioka et al, 12 no association was found between chronic sinusitis and severe, steroid-dependent asthma in adult patients. However, Bresciani et al 13 found that a greater degree of clinical rhinosinusitis severity and sinus CT abnormality in patients with severe compared to mild-to-moderate asthma.…”