Is it known why late-onset/adult-onset asthma harder to treat and control?

What a great question, - I found an article Medical News Today that states, "Asthma that develops in childhood often involves symptoms that come and go. In adult-onset asthma, symptoms are more likely to be persistent and less well-controlled.

Adults that develop asthma may have faster lung function decline than children. Adults, especially by middle age, may have stiffening of the chest wall, which can make treating asthma more difficult." last updated May 23, 2023 -
https://www.medicalnewstoday.com/articles/325302#vs-childhood-asthma


Hope this is helpful. I will definitely swing back around and see what others have to say as this is quite an interesting topic. Wishing you the best during this holiday season. Rebecca (community moderator)

Hi. A great question by you, and it really gets me thinking, as I have done lots of research into differences between childhood and adult-onset asthma. While there may be a variety of theories (guesses) explaining this, I think there is one that sums it up best. One theory says that the differences in childhood and adult onset asthma is the type of airway inflammation that is present. A few years ago, one allergist told me that nearly 100% of childhood-onset asthma is allergic, and so they tend to have Th2 inflammation (https://asthma.net/living/th2-dominant-asthma). And this type of inflammation responds very well to traditional asthma medicines (bronchodilators, corticosteroids, etc.). Those with adult-onset asthma tend to have different types of airway inflammation that tends to be stubborn and more resistant to traditional asthma medicines -- making them more difficult to control. Good examples here are eosinophilic asthma (https://asthma.net/living/persistent-eosinophilic) and neutrophilic asthma (https://asthma.net/living/subgroups-the-basics-of-neutrophilic) -- both of which are more likely to occur in adults than children. Actually, another article you may find helpful is this one (https://asthma.net/living/subgroups-the-basics-of-neutrophilic). Do you find this information helpful? John. community moderator.

Thank you so much! I do find these helpful!

Great question. I acquired asthma at the age of 65. I remember that my grandmother acquired it in her sixties too. For me, it is mostly neutrophillic; difficult to control, constant, doesn't respond all that well to steroids. Now 8 years on I have developed allergic asthma as well! It is pretty limiting and I experience it every single day to some degree. And now I have itchy eyes and a runny nose as well. It certainly is a debilitating illness.