Epidemiological | Increased morbidity and mortality Less frequent atopy |
Clinical | Underdiagnosed and undertreated Asthma control more difficult to achieve Reduced perception of symptoms Difficulties to perform pulmonary function tests Numerous co-morbidities |
Pathophysiology | Mixed (more neutrophilic airway inflammation) More severe airway obstruction Loss of lung elastic recoil – reduced respiratory muscles strength- small airways involvement Systemic inflammation and immunosenescence |
Management problems | Insufficient understanding of the disease Memory impairment, hearing loss, poor sight Psycho-socio-economic problems |
Therapy | Poor adhesion to therapy and follow-up Poor inhaler technique (arthritis, understanding…) Polypharmacy and increased risk of interactions |
General | Poor nutrition, sedentarity, weight gain Reduced access to care |