Can You Get Asthma as an Adult?

Suchandrima Bhowmik
·6 min read
<p>Liubomyr Vorona / Getty Images</p>

Liubomyr Vorona / Getty Images

Medically reviewed by Brian Bezack, DO

Adult-onset asthma is a type of asthma that develops for the first time in adulthood, typically 20 years of age and above. It's slightly more common in people assigned female at birth (9.8%) than in people assigned male at birth (6.1%). Like other types of asthma, adult-onset asthma is characterized by inflammation and narrowing of lung airways.

The exact cause of adult-onset asthma is unclear. However, several factors may play a role in its development including exposure to allergens, hormonal changes, obesity, stress, and other health conditions.

People with symptoms of adult-onset asthma may consider visiting their healthcare providers as soon as symptoms arise for proper diagnosis and treatment. This is because adult-onset asthma causes persistent symptoms and leads to a faster decline in lung function.

Adult-Onset Asthma Symptoms

The symptoms of adult-onset asthma are similar to other types of asthma. A few common symptoms include:

  • Cough, especially at night

  • Shortness of breath

  • Wheezing (a whistling sound that occurs while breathing)

  • Tightness in chest

  • Disturbed sleep

  • Colds that affect the chest and persist for 10 days or more

Causes

The exact cause of adult-onset asthma is not yet clear. About 30% of adult asthma cases arise due to allergies. This can be due to exposure to allergens (substances that activate your immune system) or other environmental triggers. Your immune system also weakens with age, which might make you more sensitive to allergies.

Common allergens or irritants include:

  • Tobacco smoke

  • Mold

  • Chemical fumes

  • Dust

  • Toxic gases or vapors

  • Perfumes

Other factors that can lead to adult-onset asthma include:

  • Hormonal changes (e.g., during pregnancy or menopause)

  • Obesity

  • Psychological stress

  • Continuous and repeated exposure to polluted air

  • Respiratory tract infections such as sinusitis, flu, or colds

  • Digestive conditions including acid reflux, heartburn, or gastroesophageal reflux disease (GERD)—a gastrointestinal (GI) disorder that occurs when stomach acid repeatedly flows back into your esophagus

How Is Adult-Onset Asthma Different From Childhood Asthma?

Childhood asthma develops before 6 years of age. Childhood asthma and adult-onset share some similar symptoms, but there are several differences:

  • Sex differences: The onset of childhood asthma is higher among children assigned male at birth compared to children assigned female at birth. Adult-onset asthma shows the opposite trend.

  • Risk factors: Childhood asthma has a strong genetic connection. Other possible risk factors include viral respiratory infections and smoke exposure early in life. The risk factors for adult-onset asthma are unclear.

  • Prognosis: Childhood asthma is generally mild and symptoms tend to improve with treatment. Adult asthma is more severe and associated with a faster decline in lung function even with treatment. Medications—such as beta-blockers or aspirin—that treat other health conditions can also increase the severity of adult-onset asthma symptoms.

Diagnosis

Reach out to your healthcare provider if you experience asthma symptoms. They will ask about your symptoms, medical history, and family medical history, and perform a physical examination. They might recommend lung function tests (breathing tests) and allergy tests to confirm asthma and rule out other conditions.

The following tests can help confirm an adult-onset asthma diagnosis:

  • Spirometry: This is the most common lung function test. It measures how much air you can breathe in and out of your lungs and how fast you can blow air out of your lungs.

  • Methacholine challenge test: This test helps determine how responsive your lungs are. You inhale doses of methacholine—a drug that narrows your airways. A breathing test takes place after each dose to determine the degree of airway narrowing.

  • Fractional exhaled nitric oxide (FeNO) test: This test measures the amount of nitric oxide present in air exhaled from your lungs. Higher levels of nitric oxide indicate swelling in the airways.

  • Chest X-ray: This imaging test can help providers understand the condition of the lungs in people with severe asthma symptoms.

Treatment Options

Treatment for adult-onset asthma depends on the severity of your symptoms and the presence of any other underlying medical conditions.

Common medications that can help to improve adult-onset asthma symptoms include the following:

  • Bronchodilators: These medications help relax and open the airways, improving asthma symptoms. Short-acting bronchodilators relieve symptoms almost instantly for 3-6 hours. Long-acting beta-agonist bronchodilators relieve symptoms for 12-24 hours.

  • Controller medications: These medications reduce swelling and inflammation in the airways. Inhaled corticosteroids and leukotriene modifiers are the two most common types. In severe cases, healthcare providers may also recommend oral corticosteroids (pills).

  • Combination medications: Combination medications involve administering two or even three types of medications at once. Combination medications may involve combining an inhaled corticosteroid with long-acting or short-acting beta-agonist bronchodilators.

  • Biologics: These medications target proteins, cells, or pathways involved in causing inflammation. They focus on treating the source of symptoms rather than the symptoms themselves, thereby helping control asthma symptoms long-term.

  • Bronchial thermoplasty (BT): Bronchial thermoplasty might be recommended for people with severe and persistent asthma symptoms that don't respond to traditional treatment. This surgical procedure involves inserting a long tube (bronchoscope) into the lungs. It helps shrink muscle tissue in the lungs and improve airflow.

How To Cope With Adult-Onset Asthma

Monitoring your asthma regularly is important to manage the condition. The following strategies may be helpful:

  • Develop an asthma action plan: Developing an asthma action plan with your healthcare provider can help you self-manage your asthma.

  • Take prescribed medications: Taking medications (in proper doses) as prescribed by your healthcare provider can improve your asthma symptoms and prevent them from worsening.

  • Identify your asthma triggers: Identifying what triggers your asthma can help you understand what to avoid to reduce your risk of symptoms.

  • Use a peak flow meter: A peak flow meter is a device that helps monitor changes in your airways. You may want to measure your peak flow at least once daily before taking your asthma medications.

  • Manage other health conditions: Following treatment guidelines for health conditions that affect asthma severity—such as respiratory or digestive conditions— can help keep your asthma under control.

A Quick Review

Adult-onset asthma is asthma that develops when you are 20 years of age or older. Symptoms are similar to other types of asthma, but the exact cause is unknown. Adult-onset asthma shares some symptoms with childhood asthma, but the risk factors and prognosis are among the key differences.

Reach out to your healthcare provider if you experience symptoms of adult-onset asthma. If left untreated, it may lead to significant loss of lung function. Several treatment approaches are available based on your symptom severity and other underlying health conditions. Taking prescribed medications as directed, developing an asthma action plan, and avoiding your asthma triggers can prevent the condition from worsening.

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