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Asthma Among Medicare Beneficiaries 65 Years of Age and Older
Recent national data indicates that 8% of adults ages 18 and older in the United States have current asthma (Centers for Disease Control and Prevention, 2023). However, those rates vary based on sex, race, ethnicity, and age. Among U.S. adults, asthma is more prevalent in females (9.7%) compared to males (6.2%). In terms of race and ethnicity, asthma is most prevalent in non-Hispanic American Indian/Alaskan Natives (13.3%), followed by non-Hispanic Blacks (10.7%), and non-Hispanic Whites (8.0%). It is least prevalent among Hispanics (6.7%) and non-Hispanic Asians (4.2%).
When looking more specifically at older adults (ages 65 and older), 7.2% have current asthma nationally, accounting for approximately 20% of individuals with asthma in the United States (Centers for Disease Control and Prevention, 2023). However, asthma prevalence is likely higher among older adults, as it is widely understood to be underdiagnosed in the older population (Gibson et al., 2010). This is attributed to a combination of factors unique to older adults, including changes in lung structure and function (Dunn et al., 2017), challenges administering and interpreting pulmonary functioning tests used for diagnosis (Battaglia et al., 2016), an increase in comorbidities such as chronic obstructive pulmonary disease (COPD) (Tzortzaki et al., 2011), and complications related to polypharmacy (Battaglia et al., 2016). Additionally, asthma tends to be less controlled in older adults when compared to younger age groups, and mortality rates tend to be higher (Tsai et al., 2012; Talreja & Baptist, 2011). For example, asthma mortality rates in 2021 increased throughout the lifespan, with rates as low as 1.4 per million among those 0-4 years old, 2.4 per million among those 5-11, 2.0 per million among those 12-17, 3.8 per million among those 18-24, 6.4 per million among those 25-34, 11.5 per million among those 35-64, and 27.1 per million among those 65 and older (Centers for Disease Control and Prevention, 2023). The underdiagnoses, in conjunction with high mortality rates and a lack of literature on the disease among older adults, indicate a need for further investigation.
