Man sitting on examination table, holding chest while talking to doctor
Researchers are not sure why asthma may develop in adulthood as opposed to childhood.

Adult-Onset Asthma

Asthma, which causes inflammation and constriction of the airways, can affect both children and adults. When it is adult-onset asthma, it may be even harder to control. Understanding the symptoms, causes and treatments for asthma in adults can help you control the disease.

What is Adult-Onset Asthma?

Asthma is a long-term or chronic lung disease that may affect people of all ages. It often first develops in children. But it can also occur later in life. When the condition develops in adulthood, it is called adult-onset asthma.

Adult-Onset Asthma Causes and Risk Factors

Researchers are not sure why asthma may develop in adulthood as opposed to childhood. But it appears exposure to certain chemicals or substances, often in the workplace, may lead to adult asthma. According to the American Academy of Allergy, Asthma, and Immunology, asthma is thought to occur due to occupational exposures.

Just as allergies may be responsible for asthma in children, they may also be to blame for adult-onset asthma. The Asthma and Allergy Foundation of American estimates that about 30% of adult-onset asthma develops due to allergies. Additional risk factors for developing adult-onset asthma include being obese and being female.

Adult-Onset Asthma Symptoms

Symptoms of adult-onset asthma can start any time, such as in a person’s 20s, 30s, 40s or even later. Symptoms may vary in severity and can sometimes be confused with other conditions. For example, emphysema is a common lung disease that usually develops in adulthood.

Because adult asthma can mimic other conditions, it might not be diagnosed as quickly as it is in children. In some cases, adults may not seek professional medical treatment as fast as parents do for their children, which also delays a diagnosis.

Symptoms of adult-onset asthma usually include the following:

  • Shortness of breath.
  • Wheezing.
  • Coughing.
  • Chest tightness.
  • Respiratory infections that linger.

How Adult-Onset Asthma Differs From Childhood Asthma

Asthma that develops in both adulthood and childhood leads to inflammation and constriction of the airways. Increased mucus production may also develop. The combination makes it difficult to breathe.

Although asthma has the same symptoms regardless of the age of onset, there are some differences in adult and childhood asthma.

Everyone has their own unique experience with asthma. But in general, asthma that develops in childhood involves symptoms that may develop occasionally. In adults, symptoms typically persist. Adults usually have a faster decline or decrease in lung function than children. Adults are also more likely to have other medical issues, which may need to be taken into account when prescribing asthma treatment.

Asthma-related deaths are much higher in adults than in children. According to the Centers for Disease Control and Prevention, almost 3,400 adults died from an asthma attack in 2015, as opposed to 219 children that same year.

Higher asthma-related deaths in adults may occur due to a combination of factors including less effective treatment, and adults waiting too long to seek help for an asthma attack.

Adult-onset asthma also differs from childhood asthma in that it usually does not go away. In some cases, asthma may go away in children as they get older, especially if it was mild. But with adult-onset asthma, the disease usually does not go away.

Diagnosis

Adults that have symptoms of asthma should see their health care provider to get an accurate diagnosis. Usually, adult-onset asthma is diagnosed using a combination of factors. After a review of symptoms and medical history, additional diagnostic tests are often ordered. Tests to diagnose adult asthma may include:

  • Chest x-ray: A chest x-ray cannot diagnose asthma. But it can rule out other conditions that may have similar symptoms, such as pneumonia.
  • Arterial blood gas test: An arterial blood gas test measures the amount of oxygen and carbon dioxide in the lungs. It also does not directly diagnose asthma. But it helps doctors determine if gas exchange in the lungs is efficient.
  • Lung function test: Lung function tests involve breathing in and out of special machines that measure air flow. It helps determine if you have a decrease in lung function based on what is considered average lung volumes for your age, sex and height. A lung function test is also useful in differentiating between asthma and emphysema.
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Adult-Onset Asthma Treatment

Adults that develop asthma can take an active role in their treatment. Although asthma is chronic, it can be managed. Usually, an adult-onset asthma treatment plan involves a combination of the following strategies:

Breathing Medications

Different types of breathing medications are usually prescribed to treat adult-onset asthma. Respiratory medications come in different forms, including a nebulizer solution, meter dose inhaler and dry powder.

Various classifications of medications are used. For example, fast-acting bronchodilators treat sudden symptoms of asthma, such as wheezing and chest tightness. They work by relaxing the muscles of the airways, which causes widening and makes it easier to breath. Examples of fast-acting bronchodilators include albuterol and Xopenex.

Long-acting bronchodilators can also play a role in treating adult-onset asthma. They work differently than fast-acting inhalers and are not taken to treat sudden symptoms. Instead, they keep the airways open longer than fast-acting inhalers and prevent asthma symptoms. They are typically taken daily even if symptoms are not present.

Inhaled corticosteroids are sometimes used as part of an adult-onset asthma treatment plan. Inhaled steroids are also not used to treat sudden asthma symptoms. They prevent symptoms by decreasing inflammation in the airways.

Allergen Reduction

Another part of an adult asthma treatment plan is decreasing allergens that may be leading to asthma symptoms. It may not always be evident which allergen is causing asthma symptoms. But it is important to keep track of when symptoms develop and try to determine if it is due to an allergy. If a particular allergen is identified, you may be able to make certain changes to reduce exposure.

Lifestyle Changes

One of the most effective ways of reducing adult-onset asthma symptoms is refraining from smoking cigarettes or being exposed to secondhand smoke. Adults with asthma that smoke tend to have more frequent and severe asthma attacks. Smoking also contributes to the development of other lung diseases, such as emphysema and chronic bronchitis.