Screening older patients for obstructive airways disease

Many studies have shown an increase in the number of cases of obstructive airways disease (asthma and chronic obstructive airways disease) in all age groups over the last few decades.1 2In the elderly, breathlessness is a common symptom3 and is increasingly common with age.4 A large number of patients with this symptom will have obstructive airways disease5 6 and estimates of the proportion of the elderly population who have evidence of chronic airways obstruction range from 20%7 8 to 30%.6 Some elderly subjects with objective evidence of obstructive airways disease will not have received a formal diagnosis6 9 and will not be receiving any specific treatments.9 Many patients may be untroubled by their symptoms10 or have adapted to them.5In response to these findings, several authors have recommended screening for obstructive airways disease in elderly patients.11 12 The premise is that the prevalence of respiratory symptoms in the elderly is high and therefore a considerable proportion of elderly subjects will have obstructive airways disease. Screening in primary care will identify those with obstructive airways disease, allowing therapeutic intervention to be applied which will lead to reduced morbidity and mortality in the treated subjects. However, before general practices invest the resources into screening for obstructive airways disease in the elderly, there must be good evidence for their doing so.

As there are no …