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Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study

Citation

Tan, DJ and Walters, EH and Perret, JL and Burgess, JA and Johns, DP and Lowe, AJ and Lodge, CJ and Hayati Rezvan, P and Simpson, JA and Morrison, S and Thompson, BR and Thomas, PS and Feather, I and Giles, GG and Hopper, JL and Abramson, MJ and Matheson, MC and Dharmage, SC, Clinical and functional differences between early-onset and late-onset adult asthma: a population-based Tasmanian Longitudinal Health Study, Thorax, 71, (11) pp. 981-987. ISSN 0040-6376 (2016) [Refereed Article]

Copyright Statement

Copyright 2016 the Author(s)

DOI: doi:10.1136/thoraxjnl-2015-208183

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.

Item Details

Item Type:Refereed Article
Keywords:Asthma Epidemiology, Respiratory Measurement
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Epidemiology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Walters, EH (Professor Haydn Walters)
Author:Johns, DP (Associate Professor David Johns)
ID Code:109582
Year Published:2016
Web of Science® Times Cited:5
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-06-22
Last Modified:2017-11-03
Downloads:0

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