Abstract
Background: Information on the epidemiology of asthma in relation to age is limited and hampered by reporting error. To determine the change in the prevalence of asthma with age in young adults we analysed longitudinal data from the European Community Respiratory Health Survey.
Methods: A self-administered questionnaire was completed by 11 168 randomly selected subjects in 14 countries in 1991–3 when they were aged 20–44 years and 5–11 years later from 1998 to 2003. Generalised estimating equations were used to estimate net change in wheeze, nocturnal tightness in chest, shortness of breath, coughing, asthma attacks in the last 12 months, current medication, "diagnosed" asthma, and nasal allergies.
Results: Expressed as change in status per 10 years of follow up, subjects reporting asthma attacks in the previous 12 months increased by 0.8% of the population (95% CI 0.2 to 1.4) and asthma medication by 2.1% (95% CI 1.6 to 2.6), while no statistically significant net change was found in reported symptoms. Reported nasal allergies increased, especially in the youngest age group.
Conclusions: As this cohort of young adults has aged, there has been an increase in the proportion treated for asthma but not in the proportion of those reporting symptoms suggestive of asthma. Either increased use of effective treatments has led to decreased morbidity among asthmatic subjects or those with mild disease have become more likely to label themselves as asthmatic.
Full Text
The Full Text of this article is available as a PDF (96.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barbee R. A., Kaltenborn W., Lebowitz M. D., Burrows B. Longitudinal changes in allergen skin test reactivity in a community population sample. J Allergy Clin Immunol. 1987 Jan;79(1):16–24. doi: 10.1016/s0091-6749(87)80010-6. [DOI] [PubMed] [Google Scholar]
- Barraclough R., Devereux G., Hendrick D. J., Stenton S. C. Apparent but not real increase in asthma prevalence during the 1990s. Eur Respir J. 2002 Oct;20(4):826–833. doi: 10.1183/09031936.02.00822002. [DOI] [PubMed] [Google Scholar]
- Basagaña X., Sunyer J., Zock J. P., Kogevinas M., Urrutia I., Maldonado J. A., Almar E., Payo F., Antó J. M., Spanish Working Group of the European Community Respiratory Health Survey Incidence of asthma and its determinants among adults in Spain. Am J Respir Crit Care Med. 2001 Oct 1;164(7):1133–1137. doi: 10.1164/ajrccm.164.7.2012143. [DOI] [PubMed] [Google Scholar]
- Brogger J., Bakke P., Eide G. E., Johansen B., Andersen A., Gulsvik A. Long-term changes in adult asthma prevalence. Eur Respir J. 2003 Mar;21(3):468–472. doi: 10.1183/09031936.03.00056103. [DOI] [PubMed] [Google Scholar]
- Burney P. G., Britton J. R., Chinn S., Tattersfield A. E., Papacosta A. O., Kelson M. C., Anderson F., Corfield D. R. Descriptive epidemiology of bronchial reactivity in an adult population: results from a community study. Thorax. 1987 Jan;42(1):38–44. doi: 10.1136/thx.42.1.38. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burney P. G., Chinn S., Rona R. J. Has the prevalence of asthma increased in children? Evidence from the national study of health and growth 1973-86. BMJ. 1990 May 19;300(6735):1306–1310. doi: 10.1136/bmj.300.6735.1306. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Burney P. G., Laitinen L. A., Perdrizet S., Huckauf H., Tattersfield A. E., Chinn S., Poisson N., Heeren A., Britton J. R., Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed] [Google Scholar]
- Burney P. G., Luczynska C., Chinn S., Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. doi: 10.1183/09031936.94.07050954. [DOI] [PubMed] [Google Scholar]
- DerSimonian R., Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. doi: 10.1016/0197-2456(86)90046-2. [DOI] [PubMed] [Google Scholar]
- Devereux G., Hendrick D. J., Stenton S. C. Perception of respiratory symptoms after methacholine-induced bronchoconstriction in a general population. Eur Respir J. 1998 Nov;12(5):1089–1093. doi: 10.1183/09031936.98.12051089. [DOI] [PubMed] [Google Scholar]
- Dodge R. R., Burrows B. The prevalence and incidence of asthma and asthma-like symptoms in a general population sample. Am Rev Respir Dis. 1980 Oct;122(4):567–575. doi: 10.1164/arrd.1980.122.4.567. [DOI] [PubMed] [Google Scholar]
- Eagan T. M. L., Bakke P. S., Eide G. E., Gulsvik A. Incidence of asthma and respiratory symptoms by sex, age and smoking in a community study. Eur Respir J. 2002 Apr;19(4):599–605. doi: 10.1183/09031936.02.00247302. [DOI] [PubMed] [Google Scholar]
- Magder L. S., Hughes J. P. Logistic regression when the outcome is measured with uncertainty. Am J Epidemiol. 1997 Jul 15;146(2):195–203. doi: 10.1093/oxfordjournals.aje.a009251. [DOI] [PubMed] [Google Scholar]
- Ninan T. K., Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992 Apr 4;304(6831):873–875. doi: 10.1136/bmj.304.6831.873. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Oryszczyn M. P., Annesi I., Neukirch F., Doré M. F., Kauffmann F. Longitudinal observations of serum IgE and skin prick test response. Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):663–668. doi: 10.1164/ajrccm.151.3.7881653. [DOI] [PubMed] [Google Scholar]
- Speight A. N., Lee D. A., Hey E. N. Underdiagnosis and undertreatment of asthma in childhood. Br Med J (Clin Res Ed) 1983 Apr 16;286(6373):1253–1256. doi: 10.1136/bmj.286.6373.1253. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Strachan D. P., Butland B. K., Anderson H. R. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ. 1996 May 11;312(7040):1195–1199. doi: 10.1136/bmj.312.7040.1195. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Torén K., Hermansson B. A. Incidence rate of adult-onset asthma in relation to age, sex, atopy and smoking: a Swedish population-based study of 15813 adults. Int J Tuberc Lung Dis. 1999 Mar;3(3):192–197. [PubMed] [Google Scholar]
- Verlato Giuseppe, Corsico Angelo, Villani Simona, Cerveri Isa, Migliore Enrica, Accordini Simone, Carolei Adriana, Piccioni Pavilio, Bugiani Massimiliano, Lo Cascio Vincenzo. Is the prevalence of adult asthma and allergic rhinitis still increasing? Results of an Italian study. J Allergy Clin Immunol. 2003 Jun;111(6):1232–1238. doi: 10.1067/mai.2003.1484. [DOI] [PubMed] [Google Scholar]
- Wolfe Rory, Carlin John B., Patton George C. Transitions in an imperfectly observed binary variable: depressive symptomatology in adolescents. Stat Med. 2003 Feb 15;22(3):427–440. doi: 10.1002/sim.1327. [DOI] [PubMed] [Google Scholar]