Impact of asthma on mortality in older women: an Australian cohort study of 10,413 women

Abstract

Background: Comorbid conditions frequently coexist with asthma in older adults and can alter the natural history of asthma, complicating management and affecting overall prognosis and survival. Objectives: This study investigates the impact of asthma on mortality among older women, with a specific interest in influence of comorbidities and social factors on survival of older women with asthma. Design Participants were from the Australian Longitudinal Study on Women's Health and were born between 1921 and 1926. Cox proportional hazards were used to evaluate mortality rates for women with and without asthma, after adjustment for comorbidities and other factors. Results: Of 10,413 women aged 73-78, 829 (8%) reported having been diagnosed by a doctor for asthma. Women with asthma had a higher likelihood of heart disease, hypertension, thrombosis, bronchitis/emphysema, osteoporosis and major illnesses (p<0.0001). Asthma was associated with increased risk of death (HR = 1.31, 95%CI 1.18-1.45, p<0.0001). After adjusting for age, demographic factors, comorbidities, risk factors, residential area and social support, women with asthma retained a 17% increased risk of death compared to women without asthma (HR = 1.17, 95%CI 1.03-1.32, p = 0.016). Conclusion: Older women with asthma have a higher rate of mortality compared with other women of the same age. This increased risk of death remains after age, demographic factors, comorbidities, risk factors, residential area and social support have been taken into account