Article Text

other Versions

PDF
Original article
Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study
  1. Daniel J Tan1,2,
  2. E Haydn Walters1,2,
  3. Jennifer L Perret1,
  4. John A Burgess1,
  5. David P Johns3,
  6. Adrian J Lowe1,4,
  7. Caroline J Lodge1,
  8. Panteha Hayati Rezvan5,
  9. Julie A Simpson5,
  10. Stephen Morrison6,
  11. Bruce R Thompson7,
  12. Paul S Thomas8,
  13. Iain Feather9,
  14. Graham G Giles1,10,
  15. John L Hopper1,
  16. Michael J Abramson11,
  17. Melanie C Matheson1,
  18. Shyamali C Dharmage1,4
  1. 1Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  2. 2NHMRC Centre of Research Excellence for Chronic Respiratory Disease, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
  3. 3Menzies Research Institute, Hobart, Tasmania, Australia
  4. 4Murdoch Children Research Institute, Melbourne, Victoria, Australia
  5. 5Biostatistics Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  6. 6Department of Medicine, University of Queensland, Brisbane, Queensland, Australia
  7. 7Department of Allergy Immunology and Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
  8. 8Department of Medicine, University of New South Wales, Sydney, New South Wales, Australia
  9. 9Gold Coast Hospital, Southport, Queensland, Australia
  10. 10Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
  11. 11Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  1. Correspondence to Dr Shyamali C Dharmage, Level 3, 207 Bouverie Street, Parkville VIC 3052, Australia; s.dharmage{at}unimelb.edu.au

Abstract

Background Differences between early-onset and late-onset adult asthma have not been comprehensively described using prospective data.

Aims To characterise the differences between early-onset and late-onset asthma in a longitudinal cohort study.

Methods The Tasmanian Longitudinal Health Study (TAHS) is a population-based cohort. Respiratory histories and spirometry were first performed in 1968 when participants were aged 7 (n=8583). The cohort was traced and resurveyed from 2002 to 2005 (n=5729 responses) and a sample, enriched for asthma and bronchitis participated in a clinical study when aged 44 (n=1389).

Results Of the entire TAHS cohort, 7.7% (95% CI 6.6% to 9.0%) had early-onset and 7.8% (95% CI 6.4% to 9.4%) late-onset asthma. Atopy and family history were more common in early-onset asthma while female gender, current smoking and low socioeconomic status were more common in late-onset asthma. The impact on lung function of early-onset asthma was significantly greater than for late-onset asthma (mean difference prebronchodilator (BD) FEV1/FVC −2.8% predicted (−5.3 to −0.3); post-BD FEV1FVC −2.6% predicted (−5.0 to −0.1)). However, asthma severity and asthma score did not significantly differ between groups. An interaction between asthma and smoking was identified and found to be associated with greater fixed airflow obstruction in adults with late-onset asthma. This interaction was not evident in adults with early-onset disease.

Conclusions Early-onset and late-onset adult asthma are equally prevalent in the middle-aged population. Major phenotypic differences occur with asthma age-of-onset; while both share similar clinical manifestations, the impact on adult lung function of early-onset asthma is greater than for late-onset asthma.

  • Asthma Epidemiology
  • Respiratory Measurement

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Airwaves
    The Triumvirate