Asthma and COPD overlap in older people

Asthma and COPD are easy to distinguish at their extremes but more difficult to differentiate in older people.1

What distinguishes asthma and COPD?

  • Asthma is often more treatment responsive (i.e. demonstrating reversibility of airflow limitation with bronchodilator) whereas COPD is characterised by persistent airway obstruction.1
  • COPD is characterised by persistence of symptoms, mainly cough and dyspnoea, despite treatment.2
  • Like asthma, COPD is characterised by intermittent acute flare ups (involving sputum production, breathing difficulties, or both) which are usually due to respiratory tract infection (RTI), and which can be significantly disabling.2

Be alert to the possibility of COPD in older patients who smoke or those with a diagnosis of asthma who do not respond to treatment as expected.2

Read more about diagnosing and managing COPD.

Diagram showing relationship of various common comorbid conditions with asthma

Chronic bronchitis and emphysema overlap with asthma.
Reproduced with permission from BMJ Thorax. 2008 September. 63(9):761–767.

  1. Postma DS, et al. Clin Chest Med 2014;35:143–56. [Pubmed].
  2. Australian asthma handbook. Melbourne: National Asthma Council Australia, 2014. [Online] (accessed 4 March 2014).