RT Journal Article
SR Electronic
T1 Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 981
OP 987
DO 10.1136/thoraxjnl-2015-208183
VO 71
IS 11
A1 Daniel J Tan
A1 E Haydn Walters
A1 Jennifer L Perret
A1 John A Burgess
A1 David P Johns
A1 Adrian J Lowe
A1 Caroline J Lodge
A1 Panteha Hayati Rezvan
A1 Julie A Simpson
A1 Stephen Morrison
A1 Bruce R Thompson
A1 Paul S Thomas
A1 Iain Feather
A1 Graham G Giles
A1 John L Hopper
A1 Michael J Abramson
A1 Melanie C Matheson
A1 Shyamali C Dharmage
YR 2016
UL http://thorax.bmj.com/content/71/11/981.abstract
AB 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.