When you’re young, you have to work hard to get out of breath. Maybe that’s from running sprints or playing a competitive game of tennis.  

As you age, though, you might get winded just climbing the stairs or raking leaves. That’s because your lungs typically don’t work as well as they used to when you were in your 20s and 30s.¹ At the same time, you may have lost some strength in your diaphragm, the muscle that supports breathing.²  

These changes can affect how you breathe. But shortness of breath can be a symptom of asthma. While you might think you’re too old to develop asthma now, that’s not true. Asthma can begin at any age.  

Doctors call it late-onset or adult-onset asthma. More than 7% of adults over the age of 65 have the condition.³ But both patients and sometimes medical professionals can fail to detect it. They might blame symptoms on natural, age-related changes. They may even mistakenly confuse the symptoms with medication side effects.³  

“This unfortunately delays diagnosis and treatment,” says Sridar Chalaka, MD. He’s the associate medical director for medical specialties at Optum Washington, in Everett, Washington. 

If you’re an older adult and think you may have asthma, here’s what to know.  
 

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What is asthma?  

Asthma is a long-term condition that affects your lungs, says Dr. Chalaka. It’s caused by inflammation in the airways or bronchial tubes in the lungs. 

In other words, asthma causes your airways to swell and narrow. They may also produce extra mucus. These factors make it harder to pull air in and out of your lungs.⁴ 

That’s why the most common signs of asthma are mostly breathing-related and include:^{3, 4} 

• A wheezing sound when you breathe 
• Coughing 
• Shortness of breath 
• Tightness in your chest 

These symptoms can occur any time. Sometimes they even wake you up at night.³ And if you have a family history of asthma, your risk may be higher.⁵ 

If you suspect you have asthma, make an appointment with your primary care doctor to discuss your symptoms. It’s important to get a diagnosis and treatment. Doing so could improve your quality of life.  

And it could be a matter of safety too. Of the 3,500 people who die of asthma each year, nearly half of them are over 65.⁵  

How does my doctor diagnose asthma?  

Some of the symptoms associated with asthma may be caused by other conditions. These include allergies, heart failure, acid reflux and even obesity.⁶ Your doctor might start with physical exam and review your medical history. Then they’ll give you a quick, easy breathing test.  

This is called a spirometry test. Your provider will ask you to blow repeatedly into a tube as hard and fast as you can, and a computer will take measurements. This measures the strength of your lungs.⁷ 

Did you know that your Optum Care doctor can diagnose chronic health conditions like asthma? And refer you to specialist too? Find an Optum doctor. 

What are some common asthma triggers? 

After you’re diagnosed, you’ll want to identify your asthma “triggers.” These are certain activities or other factors that make asthma attacks happen.⁸

Dr. Chalaka explains it like this: If asthma is like having hot embers inside the air tubes in your lungs, triggers are like gasoline on the embers. They stir up a “blaze” of inflammation in the airways. This leads to swelling in the air tubes, excessive mucus production, coughing, wheezing and shortness of breath.  

Common asthma triggers include:^{5, 8} 

• Allergens: The common ones are animal dander (dead skin cells), dust mites, pollen and ragweed.  
• Smoke: Cigarette smoke is the big one. But Dr. Chalaka warns that smoke from barbecue pits, campfires or forest fires can also trigger attacks. 
• Viral infections: Respiratory illnesses such as the flu and COVID-19 can affect your ability to breathe. If you come down with one of these, it’s likely to make your asthma worse too. 
• Extreme weather: Weather conditions such as high humidity and extreme cold can make attacks more likely. 

How does my doctor treat asthma? 

With the help of your Optum doctor or a specialist (such as a pulmonologist, who specializes in lung conditions), you can create an asthma treatment plan that works best for you, says Dr. Chalaka.  

This will likely include a mix of:  

• Coaching on how to avoid triggers 
• Lifestyle modifications (such as quitting smoking and weight loss)^{8, 9} 
• Learning to monitor asthma symptoms¹⁰ 
• What to do if you’re having an attack and how to know if it’s an emergency 

In addition, your doctor may recommend medications. These can include inhalers and oral medication. You might have a daily medication for asthma maintenance and another one for quick relief during an attack.¹¹  

With an expert from the Optum health care team to guide you, you can breathe easier. You’ll know that you have someone on your side to give you personalized treatment. That’s the Optum way.  

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