Allergy Asthma Immunol Res.  2018 Jul;10(4):387-396. 10.4168/aair.2018.10.4.387.

High Prevalence of Asthma in Elderly Women: Findings From a Korean National Health Database and Adult Asthma Cohort

Affiliations
  • 1Department of Allergy and Respiratory Medicine, Konkuk University Hospital, Seoul, Korea.
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Department of Internal Medicine, Haeundae Paik Hospital, Inje University, Busan, Korea.
  • 4Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. yscho@amc.seoul.kr
  • 5Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, Korea.
  • 6Graduated School of Public Health, Seoul National University, Seoul, Korea.
  • 7Division of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

Abstract

PURPOSE
The prevalence and burden of asthma is increasing worldwide. In this study, we analyzed 3 different Korean national health survey datasets to determine the general features of adult asthma in Korea and to obtain basic information that would support future strategies for better management of adult asthma.
METHODS
The surveys used in this study included the Korea National Health and Nutrition Examination Survey (KNHANES), Korea Community Health Survey (KCHS) and National Health Insurance Service-National Sample Cohort (NHIS-NSC). We investigated annual asthma prevalence, evaluating the rate and risk factors of asthma exacerbation by age and sex, and clinical data of 1,832 patients with asthma who were registered in the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) were analyzed to elucidate risk factors for asthma exacerbation. We also analyzed another asthma cohort and added it as replication data.
RESULTS
In the KNHANES database, annual asthma prevalence rates varied from 1.2% to 3.1%. In the KCHS database, overall prevalence increased, with significant regional differences (1.6%-2.1%). The NHIS-NSC indicated a gradual increase in annual asthma prevalence from 4.5% to 6.2%. Interestingly, all 3 surveys indicated the highest prevalence of asthma among elderly women. In addition, elderly women with asthma had a significantly higher risk of asthma exacerbation (odds ratio [OR], 1.87; 95% confidence interval [CI], 1.19-2.93; P=0.006). Approximately 11% of patients were classified as having severe asthma. An asthma cohort analysis identified female sex, low baseline pulmonary function, longer treatment duration, high variability in pulmonary function and significant changes in Asthma Control Test scores as risk factors for asthma exacerbation.
CONCLUSIONS
The prevalence of asthma in Korea is consistently high among elderly and female populations. These results should lay the foundation for strategies for effective asthma prevention and management; elderly female patients with asthma should receive particular attention.

Keyword

Prevalence; incidence; asthma

MeSH Terms

Adult*
Aged*
Asthma*
Cohort Studies*
Dataset
Female
Health Surveys
Humans
Incidence
Korea
National Health Programs
Nutrition Surveys
Prevalence*
Risk Factors

Figure

  • Fig. 1 Prevalence of asthma in Korea: KNHANES database and NHIS-NSC from 2001 to 2013. KNHANES, Korea National Health and Nutrition Examination Survey; NHIS-NSC, National Health Insurance Service-National Sample Cohort.

  • Fig. 2 Incidence of asthma by sex from 2004 to 2012: NHIS-NSC database. NHIS-NSC, National Health Insurance Service-National Sample Cohort.

  • Fig. 3 Asthma severity and exacerbation: NHIS-NSC database. (A) Distribution of asthma severity from 2002 to 2012. (B) Asthma exacerbation rate from 2002 to 2012. NHIS-NSC, National Health Insurance Service-National Sample Cohort.

  • Fig. 4 Risk of asthma exacerbation by sex: COREA asthma cohort analysis. (A) According to baseline lung function. (B) According to treatment onset age.


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