Asthma in Older Adults: A Systematic Review of Real-World Burden and Outcomes

This review examines asthma in older adults over the past decade, focusing on epidemiology, diagnostic challenges, and current management. It also explores why asthma remains underdiagnosed and undertreated in this population. Asthma prevalence is increasing among older adults worldwide, particularly in developed regions and Asia, yet underdiagnosis and undertreatment remain common. Diagnostic complexity is driven by atypical presentations, comorbidities, overlapping COPD features, and limitations of standard diagnostic criteria. Patient-related barriers include low health literacy, poor inhaler technique, symptom misattribution, psychological comorbidity, and limited social support. Access to biologic therapies remains uneven, and precision medicine approaches for older adults are lacking. Asthma in older adults is an important and underrecognized public health issue. Better awareness, age-adapted diagnostic protocols, improved inhaler education, and more integrated management of comorbidities are needed to improve outcomes and quality of life.