Asthma in adulthood: Why it happens and what to do

After experiencing difficulty breathing in December 2021, Rhonda Hesslink, 62, went to her local hospital for help.

“We assumed it was Covid, but after some tests that was ruled out. I was eventually diagnosed with pneumonia and admitted to hospital,” says Rhonda.

After X-rays and tests, Rhonda was told she may have chronic obstructive pulmonary disease (COPD). “I was adamant I didn’t have COPD because I have never smoked and none of my family smoked,” she says.

When her doctor suggested it might be adult asthma, Rhonda felt this was more accurate.

“I have 2 children with asthma, so I knew what that looked like. Even though I was surprised someone my age could be diagnosed with asthma, it felt right to me.”

Rhonda was diagnosed with asthma and put on a range of medication and oxygen to help control her breathing.

Asthma is common in Australia, with almost 2.8 million people living with the chronic disease.¹

While it is more common in children, late-onset or adult-asthma can occur at any age, even into your 60s and 70s.²

Late-onset asthma occurs any time after adolescence.

It is different from most childhood asthmas as it is less likely to be allergy related and more closely related to deteriorating lung function.³

Adult asthma is also less likely to be well managed than childhood asthma, perhaps because symptoms can sometimes be similar to what people associate with natural ageing, such as fatigue, lack of mobility and breathlessness.

This also means that adult asthma is often ignored or misdiagnosed.

Signs and symptoms of adult asthma are similar to childhood asthma and may include:

• breathlessness or shortness of breath
• wheezing
• persistent cough, especially at night or early in the morning
• a feeling of tightness in the chest.⁴

Around 10% of adult asthma cases in Australia are due to exposure to pollutants or chemicals at work. Some people will react immediately, whereas others may not start feeling unwell for some hours after exposure.³

“Adults can develop asthma over time from indoor air pollution at work or home, such as breathing fumes that irritate the lungs, or breathing in dusts that they are allergic to,” says Associate Professor Debbie Rigby, Clinical Executive Lead at the National Asthma Council Australia.

“Some common triggers in the workplace include chipboard, western red cedar, baker’s flour, epoxy resins and animal dander.”

Women are slightly more likely to get adult asthma, and diagnosis can coincide with menopause.⁵

Some lifestyle and age issues can also have an impact for both sexes, says Rigby.

“Late-onset asthma may also be due to obesity and smoking. There is also a significant association between lower respiratory tract infections and adult-onset asthma. Reflux also increases with age and may contribute to asthma attacks.”

Adult asthma may have serious health repercussions if left untreated, such as a permanent narrowing of the airways. Adults are also 6 times more likely to die from asthma than children, and less likely to treat their asthma with the correct medications.⁶

If adult asthma is not treated and managed, it can lead to sick days from work and a lack of engagement with activities that you used to enjoy. It can also impact your relationships and mental health.⁷

“Regular preventive therapy is important for all adults and adolescents,” says Professor Rigby. “Correct inhaler technique is important, but older people may experience more challenges in using their inhaler, due to dexterity, frailty, arthritis in the hands and poor eyesight.”

Rhonda now leaves the lawn mowing to her husband, Joe.

“I can feel a difference in my breathing when he cuts the grass, so I’m now banned from doing any yard work,” she says, adding that her symptoms are usually worse in the afternoon and evening when she can feel particularly tired.

“There are things I can’t do now that I used to be able to, like lifting heavy things and even standing for too long, without difficulty breathing. But the medications help and I’m learning more how to manage my breathing when it gets laboured.”

“I sit down, I do deep breathing techniques called ‘rescue breathing’ and I think of something positive to distract myself,” Rhonda adds.

If you or a loved one is having any of the symptoms listed above, see your GP.

They will ask you questions, including if you have any family history of asthma, and may suggest a test to see if you do have asthma.

If you are diagnosed with asthma, your doctor will create an asthma action plan that tells you and/or your carer what to do when you experience symptoms, when to take your medication and when to go to hospital in an emergency.

If at any time you or someone else is struggling to breathe, dial triple zero (000) or go to an emergency room.

It is important that you do not ignore asthma-type symptoms, as delay in treatment can lead to further health issues.

Allergy & Anaphylaxis Australia offers more information on how to reduce your exposure to allergens. Visit their website or call them on 1300 728 000.

The National Asthma Council Australia provides information and support for those living with asthma. This includes their Asthma first aid Instructions.

Asthma Australia offers support and advice online or by phone on 1800 278 462