Table 1. Strategies to improve the care of older women with asthma.

Menopause is often associated with worsening asthma. Hormone replacement therapy can help, however risks/benefits should be considered. Elderly women are at increased risk of fracture and ocular effects from an inhaled corticosteroid. Periodic bone mineral density screenings and ophthalmological examinations are appropriate. A peak flow meter can help to overcome decreased perception of breathlessness. Discuss comorbidities and emphasize that control of asthma will allow the older asthmatic woman to better manage other medical conditions. Screen for depression and treat or refer as appropriate, given the high prevalence of depression among older women and its strong association with asthma For obese or overweight older women with asthma, work with the patient and primary care provider to encourage weight loss. Assess caregiving roles that your patient may have. Connect her with appropriate resources. Limited income or poverty is common among older women. Determine the financial abilities of your patient to comply with recommended therapies. Incorrect inhaler use is common among the elderly. An asthma educator can teach over 90% of older adults how to properly use an inhaler. There is decreased responsiveness to short acting β-agonists among the elderly. Consider manipulation of the anticholinergic and/or leukotriene pathways.