Asthma when you're older

As we age, our lungs become weaker and our immune system can take longer to fight off infections.  

As a result, you may notice a few changes to your asthma symptoms as you get older:

• Symptoms may feel harder to control  
• It can take longer to recover from colds and flu  
• Side effects from asthma medicines can be harder to control 
• Other conditions alongside asthma are more common e.g. acid reflux and rhinitis.

Asthma diagnosed later in life is known as late-onset or adult-onset asthma. This kind of asthma is more common in women, often starting around the menopause.

It can be difficult to diagnose asthma in later life. This is because symptoms can be slightly different in older people. Sometimes people are misdiagnosed and as a result, treated incorrectly. For example, doctors may think you have chronic obstructive pulmonary disease (COPD) because of your age.

Late-onset asthma is often harder to control with the usual asthma medicines. Your GP may prescribe add-on treatments, like LTRAs (leukotriene receptor antagonists), or long-acting bronchodilators, for extra support.

Sometimes childhood asthma comes back in later life after a long time without symptoms. Asthma coming back can sometimes be caused by work (occupational asthma).  

If your asthma symptoms have returned in adulthood, you should speak with your GP or nurse. This is because there are different types of asthma. Childhood asthma can be linked to allergies, and late-onset asthma can be harder to control.

Find out more about how asthma is diagnosed.

Have regular asthma reviews

Whether you’ve had asthma all your life, or you’ve been diagnosed with it as an older adult, a yearly asthma review helps you stay on top of any changes in your symptoms.

You can make sure your asthma action plan is up to date, review your asthma medicines, and check you’re taking the lowest dose possible to stay well and avoid side effects.

Check your inhaler technique

It’s important for you to check your inhaler technique regularly. Watch our inhaler videos and ask your GP or nurse to check how you’re using your inhalers.

If you’re finding it harder to take your inhalers, perhaps due to a condition like arthritis, ask if there’s a different inhaler that might be easier for you to use.

Track your symptoms

Keeping track of your symptoms makes it easier to see any changes. Write down your symptoms in a diary, notebook, or on your phone, and take it to your next appointment.

Don’t forget to write down anything you were doing that day or any triggers you came across - you may notice you’re sensitive to new things that were not a problem before.

Measure your peak flow

Your GP can check how well you can fill your lungs with air, and how well you can breathe out again, using a peak flow test.

You can continue to measure your peak flow at home, using a peak flow meter and writing down your scores in a peak flow diary. Some people find this a helpful way to monitor their asthma.

Monitor your side effects

Talk to your GP or asthma nurse if you’re getting more side effects from your asthma medicines than usual. Side effects, like heart palpitations or feeling shaky after using your reliever inhaler, can feel worse as you get older.

Taking long-term oral steroids or high doses of inhaled steroids can increase the risk of getting glaucoma, osteoporosis, or thinner skin that bruises easily, but not everyone will experience these side effects.

Get help with other conditions

It’s common to have more than one long-term condition as you get older. Some other conditions linked with asthma, like OSA (obstructive sleep apnoea) and acid reflux, can make asthma symptoms worse.

Some of these conditions may have symptoms that overlap. For example, many of the symptoms of asthma are like those of chronic bronchitis or emphysema, which are types of COPD (Chronic Obstructive Pulmonary Disease). It is also possible to have asthma and COPD at the same time.

Avoid colds and flu

The best way to lower your risk of getting very ill with a cold or flu is to get vaccinated. Ask your GP or asthma nurse for a yearly flu vaccine, the pneumonia vaccine, and the coronavirus vaccine.

You can also lower your risk of getting a cold or other chest infections by washing your hands and staying away from friends or family who are unwell if you can. Find out more about lowering your risk. 

As well as looking after your asthma symptoms, it’s also important to look after your overall health when you’re older.

• Stay active – staying active will help you to keep your muscles strong and help you breathe more efficiently.  
• Eat well – eating the right food will help you stay fit and strong and help you to prevent chest infections. 
• Quit smoking – smoking can make your asthma symptoms worse. If you smoke, quitting is the best thing you can do for your health. 
• Look after your mental health – living with a lung condition can be difficult at times, so knowing what to do when you’re feeling anxious or depressed is important.