Depression and Asthma Outcomes in Older Adults: Results from the National Health and Nutrition Examination Survey

BACKGROUND: Older adults have high rates of asthma morbidity and mortality, as well as increased rates of depression. There are no nationally representative studies describing the association of depression on key asthma outcomes such as emergency department (ED) visits among older adults. OBJECTIVE: The objective of this study was to determine the association of depression with asthma outcomes in older adults (age >= 55) from the National Health and Nutrition Examination Survey (NHANES). METHODS: Data from the NHANES survey (2007-2012) were analyzed. Bivariate analyses and multivariate Poisson regression models were used to examine associations between depression and asthma outcomes among adults above the age of 55. RESULTS: Approximately 7.01% (n = 509) of the sample reported a physician diagnosis of asthma. Older adults with asthma and depression (n = 196) had increased asthma episodes (prevalence ratio [PR], 1.53; 95% confidence interval [CI], 1.00-2.35), ED/urgent care visits for asthma (PR, 2.24; 95% CI, 1.15-4.34), sleep disturbances due to asthma (PR 2.75; 95% CI, 1.54-4.92), and activity limitation (PR, 1.77; 95% CI, 1.00-3.18; P = .05) compared with older asthmatics without depression. They also reported worse health-related quality of life measures across 4 domains including days of poor general health, physical health, mental health, and inactivity (P < .001 for all). No significant differences in spirometric values were observed. CONCLUSIONS: Older adults with asthma and depression are nearly twice as likely to have poor asthma outcomes across several indicators, including asthma-related ED/urgent care visits compared with those without depression. Screening for depression and providing supportive resources may decrease the burden of asthma among older adults. (C) 2017 American Academy of Allergy, Asthma & Immunology