When It’s Not “Just Allergies.” What to Know About Adult-Onset Asthma
James Grant, M.D.
| 3 min read
James D. Grant, M.D., is executive vice president an...
Key Takeaways
- Adult‑onset asthma affects a growing share of the population; in Michigan the prevalence is 11.9%, higher than the national 8.2% rate, and many cases remain undiagnosed because symptoms are mistaken for allergies or a cold.
- Risk factors include a family history of asthma, long‑term exposure to pollutants or smoke, prior viral respiratory infections, allergic conditions such as hay fever or eczema and obesity, which can increase inflammation and airway irritation.
- Persistent cough, chest tightness, shortness of breath or wheezing should prompt a visit to a primary care provider for lung‑function testing; once diagnosed, adults must follow a treatment plan, avoid triggers, quit smoking and monitor side effects of medications like oral steroids.
Nearly 27 million people in the U.S., or 8.2% of the population, have been diagnosed with asthma, according to the most recent data from the U.S. Centers for Disease Control and Prevention (CDC). In Michigan, that rate is higher, at 11.9%.
What’s more difficult to estimate, however, is the number of adults who have asthma but have NOT been diagnosed.
While asthma is often diagnosed before age 20, the reality is that asthma can develop at any age. And asthma that develops in adulthood can be harder to treat.
But adults tend to assume that their symptoms are something else, like allergies or a cold, delaying the appropriate treatment that a diagnosis provides. Being aware of your risks and any symptoms you may be experiencing can help you identify and get help for asthma.
Developing asthma later in life
There are many factors that increase your risk of developing asthma. For example:
- A family history: Asthma tends to run in families. Your risk is higher if you have close relatives with asthma. And if one of your parents has asthma, your risk is six times higher.
- Ongoing exposure to pollutants: this can be from air pollution where you live, chemicals or other irritants in the workplace, or other long-term exposure.
- Smoking: Smoke irritates the airways in your lungs, and this irritation increases your risk of asthma. You also can have a higher risk if you are exposed to secondhand smoke over a period of time, like if you grew up in a household of smokers.
- Respiratory illnesses: Sometimes, children who have viral respiratory illnesses develop asthma when they are older.
- Allergies: Some types of allergic conditions, like hay fever or eczema, raise the risk of developing asthma
- Obesity: Being overweight or having obesity increases your asthma risk. Some experts believe this is due to higher inflammation levels in the body.
When to see a health care provider
If you’ve never suspected that you have asthma and you are coughing or feeling temporarily short of breath, it’s easy to attribute those symptoms to other more common things, like allergies or being out of shape.
However, if you experience these symptoms regularly, or if they are persistent, talk with your primary care provider (PCP).
- Coughing: particularly a dry, hacking cough that flares up at night or during exercise.
- Chest tightness: A feeling of pressure or like you cannot get a full, deep breath.
- Shortness of breath: Feeling like you are out of breath or breathing heavily after light physical activity
- Wheezing: A whistling sound when breathing, particularly when breathing out.
Your PCP will examine you, check your health history and may conduct some initial lung function tests. Your PCP also might recommend you see a specialist.
Managing asthma in adulthood
Treating asthma can be more difficult in adults for a variety of reasons:
- Adult-onset asthma symptoms tend to be harder to control.
- Lungs can be stiffer in older adults, making it harder to move air in and out.
- Asthma can make some heart medication less effective.
- Oral steroids for asthma can worsen other conditions like glaucoma, cataracts and osteoporosis.
Once a proper diagnosis and treatment plan is in place, the best way to manage your asthma is to stick to your plan. Take medication as directed, be aware of your asthma triggers, stop smoking and pay attention to your symptoms.
Image: Getty Images
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