View Abstract

A1411 - Age, Number of Medications, and Allergy Testing in Older Adults with Asthma
Author Block: B. J. Polivka1, A. Jorayeva2, D. Antimisiaris3, R. J. Folz4; 1School of Nursing, University of Louisville, Louisville, KY, United States, 2Nursing, University of Louisville, Louisville, KY, United States, 3Pharmacology and Toxicology, University of Louisville, Louisville, KY, United States, 4Case Western Reserve University, Louisville, KY, United States.
Rationale: Skin-prick testing (SPT) is commonly used to assess for allergies in older adults with asthma. Diminished physiological function of the older adults, disease and medication burden make them uniquely different from younger adults, as well as from one another. This study explored the number of medications used (asthma; non-asthma) and age differences among groups with distinct immune responses in older adults with asthma. Methods: This is an ancillary study to the ongoing “Asthma in Older Adults: Identifying phenotypes and factors impacting outcomes”. The parent study is a prospective cohort study of older adults with asthma. This cross-sectional investigation included 84 non-smoking adults ≥ 60 years with asthma. Participants underwent SPT and specific Immunoglobulin E (sIgE) testing for 14 allergens. Relevant medications were held prior to allergy testing based on common clinical guidelines. SPT was considered positive if wheals were ≥3 mm versus the negative control. Specific IgE results were considered positive if levels were ≥0.35 kU/L. Results: Most of the sample was Caucasian (n=68, 81%), female (n=57, 68%), and 68 (±6; range: 60-88) years old. Mean number of medications taken for asthma was 5 (±2); in addition participants reported taking an average of 7 (±5) non-asthma medications, for an overall average of 9 (±5) medications per person. Among participants, 26% had no positive SPT results, 44% had 1-4, and 30% had 5-14 positive SPT results. In contrast, sIgE testing revealed that 46% had no positive results, 33% had 1-4 positive sIgEs, and 20% had 5-14. Trend analysis revealed that compared to those with 1-4, and 5-14 positive SPT results, those with no positive SPT results tended to be older (67, 68, vs. 69 years old), used more asthma medications (2, 2, vs. 3), and non-asthma medications (7, 6, vs. 8). This trend was not seen in the sIgE findings. Conclusions: The results of this exploratory study illustrate potential challenges in allergy diagnostics as older adults with asthma age. SPT is commonly used to assess for allergies, yet this study revealed subtle, but thought-provoking trends in differences in age and number of medications used between groups with varying SPT reactivity. These factors may need to be considered by clinicians to achieve clinically meaningful results and, ultimately, effective allergen immunotherapy. Further research is warranted to examine the nature of relationships between allergen reactivity and medication types and medication combinations in this growing population of older adults with asthma.