Prevalence and classification of rhinitis in the elderly: a nationwide survey in Portugal

Abstract

Background: Nationwide epidemiologic data on rhinitis in the elderly do not exist. This study aimed to estimate the prevalence of rhinitis in the population aged 65 years or above in mainland Portugal and to characterize and classify rhinitis in this age group. Methods: Cross-sectional, nationwide, population-based survey of citizens aged 65 years or above, living in mainland Portugal. Current rhinitis (CR) was defined as the presence of at least two symptoms: 'repeated sneezing and itchy nose', 'blocked nose for more than one whole hour', or 'runny nose when not having a cold or flu', either usually or in the last 12 months.Rhinitis severity was assessed using a visual analogue scale; rhinitis was classified according to ARIA. Results: Data were obtained from 3678 responders (92.5% response rate). The prevalence of CR was 29.8% (95% confidence interval (CI): 28.4%-31.3%): 49.1% had mild intermittent, 7.0% mild persistent, 27.5% moderate-severe intermittent, and 16.4% moderate-severe persistent rhinitis. Only 38.6% of patients with CR had been physician diagnosed and 38.7% were under treatment for this disease in the previous year. Allergic conjunctivitis symptoms were referred by 68.6% of subjects with CR (rhinoconjunctivitis population prevalence, 20.5% (95% CI: 19.2%-21.8%)). Conclusions: Rhinitis and rhinoconjunctivitis are common but underdiagnosed and undertreated diseases in the geriatric population. This was the first nationwide epidemiological survey classifying rhinitis according to ARIA guidelines in this age group. More than 40% of old-age patients presented moderate-severe disease.

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

“…VAS can be used in all age groups including preschool children (guardian evaluation) (90) and the elderly (91). Furthermore, it can be used in a wide variety of languages (81,(91)(92)(93)(94)(95)(96)(97). VAS levels vary with the ARIA classification in many languages (76, 79, …”

“…The VAS represents a reliable and valid measure of rhinitis control (10, 72) (Figure 2). It can be used across the life cycle (90,91,111).…”

Allergy and asthma medication use in home‐dwelling U.S. older adults

“…As with AR, there are no good epidemiology studies of NAR in older adults. However, prevalence of rhinitis symptoms in older adults has been reported at around 30% in the United States and Portugal 1,20 ; only ~40% of such subjects reported being diagnosed with rhinitis by a physician in the Portuguese study 20 Clinicians caring for this population should therefore consider that even patients who do not present with obvious allergic disease or clinically diagnosed rhinitis may still be using these medications, many of which are available over-the-counter. Notably, use of nasal saline irrigation, a safe treatment for rhinitis 21 , was exceedingly low (0.02%), suggesting that clinicians can be more aggressive in recommending this effective therapy.…”

ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”

“…For example, visual analogue scales (VAS) assessing impact of AR, quality of life (QOL) measures, and scores with several items which cover symptoms and impact on daily living are commonly used. In deciding which measure of AR control is most appropriate, it is important for a score to be simple and responsive to change over time, as AR control changes; hence, VAS scores, which can be used in all age‐groups, are available in a wide variety of languages, and have been shown to be valid for assessing AR control, are useful instruments for assessing AR control (Figure ).…”