Differences in the efficacies of commonly used asthma questionnaires for predicting asthma-related outcomes among elderly and non-elderly patients in Japan.

Background: Elderly asthma (EA) and non-elderly asthma (NEA) have been shown to differ greatly. The aim of this study was therefore to identify any differences in the abilities of commonly used asthma questionnaires to predict asthma outcomes in patients with EA and those with NEA, and to further determine the questions that are important for outcome prediction. Methods: This study analyzed data from the NHOM-Asthma study, a nationwide asthma registry in Japan which included 1014 patients with EA (aged ≥65 years) and 842 with NEA (aged <65 years). The correlations between total scores or individual items of the Asthma Control Questionnaire 6 (ACQ6), Asthma Quality of Life Questionnaire (AQLQ), and Asthma Starts with Knowledge 20, and asthma-related outcomes (unscheduled hospital visits, acute exacerbations, admissions within 1 year, and pulmonary function test results) were analyzed. Results: Worse baseline ACQ6 and AQLQ scores were significantly correlated with worse asthma-related outcomes in patients with NEA. In contrast, in patients with EA, these scores and the individual question items showed only a weak or no correlation with asthma-related outcomes. Instead, specific questions related to wheezing, nocturnal symptoms, nasal symptoms, and activity limitations were found to be closely associated with asthma-related outcomes in patients with EA. Moreover, the oscillometry data may better reflect the severity of asthma symptoms and activity limitations, as assessed by questionnaires, than spirometry data, including the forced expiratory volume in 1 sec, in patients with EA. Conclusions: Commonly used asthma questionnaires may not be suitable for predicting outcomes in patients with EA. However, specific questions addressing factors such as wheezing, nocturnal symptoms, nasal issues, and activity limitations may serve as reliable indicators of asthma-related outcomes in these patients.