Asthma in the Elderly: Can We Distinguish It from COPD?

Table 1

Main differences between COPD and Asthma.

	COPD	Asthma
Onset	Mid life	Early or Late onset
Risk factors	Smoking	Atopy, irritant exposures, smoking
Symptoms	Slowly progressive	Intermittent
(i) Breathlessness	On moderate/minimal effort	On exacerbations
(ii) Cough	Regularly	On exacerbations
Family history	May be present	May be present
FEV1/FVC ratio	<70%	<70%
FEV1% predicted	<80%	<80%
Bronchodilator response	Absent/present	Present
Inflammatory cells	Neutrophils	Eosinophils
	Macrophages	Neutrophils
	CD8^+ cells (Tc)	Mast cells
		CD4^+ cells (Th2)
Structural changes	Airway smooth muscle +	Airway smooth muscle +++
	Peripheral airways	All airways
	Parenchymal destruction	No parenchymal involvement
	Epithelial metaplasia	Epithelial shedding
	Fibrosis++ (peribronchiolar)	Fibrosis + (subepithelial)
	Mucus secretion +++	Mucus secretion +
Steroid response	+/−	+++