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Ann Allergy Asthma Immunol. 2016 Mar;116(3):206-11. doi: 10.1016/j.anai.2015.12.005. Epub 2016 Jan 11.

Phenotyping asthma in the elderly: allergic sensitization profile and upper airways comorbidity in patients older than 65 years.

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Unità Dipartimentale di Allergologia-Immunologia Clinica & Malattie Apparato Respiratorio, Ente Ospedaliero Fondazione Poliambulanza, Brescia, Italy. Electronic address:
Unità di Igiene, Epidemiologia e Sanità Pubblica dell'Università degli Studi di Brescia, Brescia, Italy.
Unità Operativa di Allergologia, Azienda Ospedaliero-Universitaria Integrata di Verona, Verona, Italy.
Azienda Ospedaliera Cardarelli, Divisione di Pneumologia ad Indirizzo Allergologico, Napoli, Italy.
Allergy and Respiratory Diseases, University of Genoa, Genova, Italy.
Struttura Complessa di Pneumologia, Azienda Ospedaliero Universitaria S Maria della Misericordia di Udine, Udine, Italy.
Dipartimento di Medicina Clinica e Sperimentale, Università di Parma, Parma, Italy.
Pneumologia e Fisiopatologia Respiratoria, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy.
Struttura Complessa di Pneumologia, ASL 2 Savonese, Pietra Ligure (SV), Italy.



Data about allergic rhinitis in elderly patients with asthma are lacking.


To investigate the presence of rhinitis and the role of sensitization of airborne allergens in elderly patients with asthma.


This was a multicenter cross-sectional study involving subjects at least 65 years old with asthma. Demographic features, comorbidities, and the presence of allergic respiratory disease were retrieved through interview. Skin prick tests for common allergens were performed. Associations of demographic and clinical features were evaluated in relation to asthma control and forced expiratory volume in the first second less than 80% in the total population and in the subgroup with features resembling chronic obstructive pulmonary disease.


Of 368 elderly subjects with asthma, 101 had features resembling chronic obstructive pulmonary disease. Rhinitis was present in 59.0% of subjects (allergic rhinitis in 47.6%), with an age of onset significantly different from that of asthma (49 ± 18 vs 57 ± 18 years). At least 1 sensitization was observed in 52.4% of subjects, more frequently for house dust mite (HDM; 31.8%). The prevalence of poorly and partially controlled asthma was higher in patients sensitized to airborne allergens (odds ratio 1.64, 95% confidence interval 1.03-2.61), in particular to HDM (odds ratio 1.73, 95% confidence interval 1.05-2.85).


Approximately 60% of elderly subjects with asthma had rhinitis, mainly allergic and often untreated, whose onset preceded asthma symptoms by a mean of approximately 10 years. Nonallergic asthma was better controlled than allergic asthma. However, HDM sensitization was greater in subjects with asthma with features resembling chronic obstructive pulmonary disease (39% vs 28%). When restricting analysis to this group, the negative role of HDM in overall asthma control (forced expiratory volume in first second and Asthma Control Test) was significant.

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