17 November 2017

Asthma kills more older women than men

Clinical Respiratory Women

Women aged over 65 are three times more likely to die from asthma than men of the same age, according to data from the Australian Bureau of Statistics.

Out of almost 500 people who died from asthma-related causes last year, over half were older women.

A total of 257 women aged over 65 died from asthma in Australia in 2016, compared with 90 men in the same age bracket.

The ratio had not shifted over the past three years, showing that older women were consistently at greater risk of dying from asthma, Dr Jonathan Burdon, a respiratory physician and the chair of National Asthma Council Australia, said.

There were several potential reasons for the disparity between genders, he said.

Firstly, asthma was more common, in general, among women than men. The difference was small, however, and could not account for higher death rate.

Secondly, menopause was known to trigger asthma and make existing asthma more difficult to control.

A third contributor was the prevalence of comorbidities in older women, such as obesity, heart disease, and lifestyle factors, such as smoking.

Older women tended to be family carers and might not prioritise their own health, Dr Burdon said.

And, of course, patients did not always take their medication as prescribed, he said.

Around 40% of people who were prescribed daily asthma medication did not take it every day, which placed them at greater risk of dangerous flare-ups.

People with asthma were not cued to take regular medication because they did not experience ongoing symptoms, Dr Burdon said.

“So, you need to develop strategies for remembering to take your medication,” he said.

“And in the older age group that becomes more of an issue because people become a bit more forgetful or distracted.”

People aged over 75 made up over two-thirds of the deaths in 2016, indicating that age was also a major risk factor.

National Asthma Council Australia recommended that GPs discuss how controlling asthma allowed older women to better manage other conditions.

GPs could also review the patient’s inhaler technique, screen for depression as this had a strong association with asthma, and encourage weight loss in older women with asthma.

National Asthma Council Australia recently released a new, mobile-only website, called Asthma Buddy.

The website (asthmabuddy.org.au) was funded by GSK Australia but editorial control remains with National Asthma Council Australia.

It houses complete asthma action plans, which help patients keep track of medications and recall what to do in an emergency.

All patients with asthma should have their asthma reviewed on a regular basis once or twice a year, Dr Burdon said.

“The bottom line is take your medication as prescribed,” he said. “That will keep most people out of trouble.”

The ABS data showed that deaths from asthma increased 8% in 2016 compared with the previous year.

There were 13 more deaths in NSW and 11 more deaths from asthma in Victoria. The rise could partly be attributed to the thunderstorm asthma event in Melbourne on 21 November last year.