From the Guidelines
Yes, being under 18 years old, specifically age less than or equal to 17, is a risk factor for asthma. Children and adolescents have higher rates of asthma compared to adults, with childhood being a particularly vulnerable period for asthma development. This increased risk is due to several factors including smaller airways in children that are more easily obstructed, developing immune systems that may be more reactive to environmental triggers, and greater exposure to respiratory infections that can trigger asthma symptoms or lead to its development. Additionally, children's lungs are still developing, making them more susceptible to environmental irritants and allergens. The prevalence of asthma often peaks during childhood and early adolescence, with many children experiencing their first symptoms before age 5, as noted in the expert panel report 3 (epr-3): guidelines for the diagnosis and management of asthma-summary report 2007 1. However, it's essential to consider that while age is a risk factor, asthma development is multifactorial, involving genetic predisposition, environmental exposures, and other factors, as highlighted in a systematic review on the management of asthma exacerbations in the pediatric population 1. Many children with asthma symptoms may see improvement as they grow older, though some will continue to have asthma throughout adulthood. Key considerations for managing asthma in children include promoting physical activity, treating exercise-induced bronchospasm, and closely monitoring for disease progression and loss of lung growth, as outlined in guidelines for different age groups 1. Given the most recent and highest quality evidence, the risk of asthma associated with age less than or equal to 17 should be considered in the context of overall clinical assessment and management 1.
Some key points to consider in the management of asthma in children include:
- Inhaled corticosteroids are the preferred long-term control therapy for initiating treatment in children, with benefits outweighing concerns about potential risks of growth velocity reduction or other adverse effects 1.
- The selection of step-up treatment options for children whose asthma is not well controlled on low-dose ICS depends on the domain of particular relevance (impairment, risk, or both) and clinician-patient preference 1.
- Monitoring response to therapy closely is crucial, with treatment adjustments made based on clear and beneficial responses or lack thereof 1.
- Involving children in developing their written asthma action plans and reviewing adherence can help address developmental issues and improve outcomes 1.
Overall, managing asthma in children requires a comprehensive approach that considers age as one of several risk factors, along with genetic predisposition, environmental exposures, and other factors 1.
From the Research
Asthma Risk Factors
- Age is a significant factor in asthma development and management, with different age groups having varying levels of risk and response to treatment 2, 3.
- However, the provided studies do not specifically address whether age less than or equal to 17 is a risk factor for asthma.
Age-Related Considerations in Asthma Treatment
- The study by 2 included patients at least 12 years of age, indicating that age can be a consideration in asthma treatment, but it does not provide information on the risk of asthma in individuals 17 years or younger.
- Another study 3 reviewed clinical studies in children and adults with asthma, suggesting that age can influence treatment outcomes, but it does not explicitly discuss the risk of asthma in relation to age.
Lack of Direct Evidence
- There is no direct evidence in the provided studies to support or refute the claim that age less than or equal to 17 is a risk factor for asthma 4, 5, 6.
- The studies primarily focus on treatment options, such as inhaled corticosteroids and long-acting beta-agonists, and their effectiveness in managing asthma symptoms, rather than exploring age as a risk factor.