It is possible to develop asthma later in life, even if you have never experienced it before. This chronic respiratory condition, characterized by inflammation and narrowing of the airways, is not exclusively a childhood ailment. It can manifest for the first time in adulthood, affecting individuals across all age groups.
Understanding Adult-Onset Asthma
Adult-onset asthma refers to asthma diagnosed for the first time in adulthood, typically after the age of 20. This condition involves the swelling and inflammation of the lung airways, leading to increased mucus production and muscle spasms that restrict breathing. While symptoms can be similar to childhood asthma, the progression and specific triggers often differ. Adults with newly diagnosed asthma experience persistent symptoms, unlike the intermittent symptoms often seen in childhood asthma.
Adult-onset asthma can also be associated with a faster decline in lung function compared to childhood asthma. The chest wall may stiffen with age, which can complicate treatment. Adults face a higher risk of asthma-related mortality compared to children, with almost all asthma deaths in 2019 occurring in individuals over 18 years old.
Common Triggers and Risk Factors
Several factors can contribute to the development of asthma in adulthood. Exposure to new or increased levels of allergens, such as pollen, dust mites, pet dander, or mold, is a common cause, with allergies triggering at least 30% of adult asthma cases. Inhaling irritants or sensitizers in the workplace, known as occupational asthma, accounts for about 1 in 6 cases of adult-onset asthma. Over 300 substances in the workplace can trigger or worsen asthma in adults.
Severe respiratory infections, including viral infections like the flu or pneumonia, can trigger asthma symptoms. Obesity is a risk factor that increases the risk of adult-onset asthma. Hormonal changes in women, such as those occurring during pregnancy, menopause, or perimenopause, or from taking estrogen after menopause, can also play a role. Environmental irritants like secondhand smoke, air pollution, or strong chemical fumes can provoke asthma symptoms.
Recognizing the Symptoms
The symptoms of adult-onset asthma can vary in severity and may sometimes be mistaken for other conditions. Common symptoms include:
Wheezing, a whistling sound during breathing.
Shortness of breath, especially during physical exertion.
Chest tightness or pain, often described as a squeezing sensation.
Persistent coughing, particularly at night, in the early morning, or after exercise or laughing.
Difficulty sleeping due to breathing problems.
General fatigue.
These symptoms can be intermittent, appearing occasionally, or persistent, requiring daily medication for control.
Diagnosis and Management
Diagnosing adult-onset asthma involves a thorough evaluation by a healthcare professional. This process includes a physical exam, a review of the patient’s medical history, and lung function tests. Spirometry is a common lung function test that measures how much air a person can exhale and how quickly. In some cases, a methacholine challenge test is used, where a patient inhales increasing amounts of methacholine mist to see if it causes airway narrowing.
Management of adult-onset asthma focuses on controlling symptoms, preventing exacerbations, and improving overall quality of life. Treatment plans include quick-relief (rescue) inhalers, such as short-acting beta-agonists, to relax and open airways during sudden symptoms. Long-term control medications, like inhaled corticosteroids, are used daily to reduce inflammation and prevent symptoms. Identifying and avoiding personal triggers is also a key part of effective management. Regular monitoring of symptoms and lung function, alongside consistent communication with a healthcare provider, helps ensure a personalized and effective treatment strategy.