Method: Fifty mild to moderate asthmatics were enrolled over 60 years old. Questionnaires including ACT, asthma specific quality of life (AQOL), and geriatric depression scale (GDS) were performed. Seoul neuropsychological screening battery-dementia version (SNSB-D), Korean version of mini mental status examination (K-MMSE), and Seoul instrumental activities of daily living scale (SI-ADL) were done for neuropsychological assessment.
Results: Mean age was 67.0 ± 4.9 years. Thirty patients were female (60.0%). According to GINA, 12(24%) were in well-controlled, and 38(76%) were in not-controlled. However, according to ACT, 37(74%) were in ≥20 group, and only 16(32%) were in <20 group. The sensitivity and specificity of ACT to determine well-controlled asthma were 91.7% and 39.5%, respectively. Overestimation of asthma control status was 56%, using ACT compared to GINA. Regarding neuropsychological assessment, 22(44%) had mild cognitive impairment, 4(8.7%) had dementia, and 17(34%) had depression. Depression was more common in patients with uncontrolled asthma(42.1% vs. 8.3%, P=0.039). Total SNSB-D score was significantly higher in patients with ACT≥20 (187.9 vs. 217.3, P=0.015). The ACT score was significantly correlated with degree of cognitive function (adjusted using age, sex, education, and GDS; P=0.004).
Conclusion: There is discrepancy between self-reported ACT and physician’s decision by GINA in the assessment of asthma control in elderly asthma, in which ACT score is affected by cognitive function. Elderly asthmatics with higher cognitive function can achieve better asthma control.