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What Is New In Small Airways Research

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By Ves Dimov, MD
Allergist/Immunologist, Assistant Professor, University of Chicago

Posted 20 March 2013

A significant relationship between asthma and cognitive impairment in older patients

Minimal data are available on the relationship between asthma and cognitive performance.

This retrospective analysis examined the relationship between asthma and cognitive performance in older adults and included 1,380 participants aged 55 and older who completed preventive health examinations at the Cooper Clinic in Dallas, Texas, USA. Cognition was assessed using the Montreal Cognitive Assessment (MoCA), a brief test for mild cognitive impairment.

Asthma was associated with 78% increased risk of cognitive impairment. The data were controlled for demographic characteristics, self-rated health status, inhaled corticosteroid use, and FEV1/FVC.

In the largest sample examined to date, the study authors we have identified a significant relationship between asthma and cognitive impairment in older people. Further studies are indicated to confirm these results and to determine if the optimization of the asthma management can improve cognition.

Source: Caldera-Alvarado G, Khan DA, DeFina LF, Pieper A, Brown ES. Relationship between asthma and cognition: the Cooper Center Longitudinal Study. Allergy 2013; Published online before print. doi: 10.1111/all.12125

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Image Source: Hippocampus, from Wikimedia Commons, public domain.

No effect from montelukast on respiratory symptoms and lung function in wheezy infants

This study from Finland investigated the effectiveness of montelukast in recurrently wheezy infants, and randomised 113 children (6-24-month-old) with recurrent wheezing to receive either placebo or montelukast daily for an 8-week period.

There was no significant difference in symptom-free days between the two groups, or the use of rescue medication, exhaled nitric oxide fraction (FeNO) or airway parameters measured by whole-body plethysmograph, squeeze technique, and methacholine challenge.

Montelukast therapy did not influence the number of symptom-free days, use of rescue medication, or lung function in recurrently wheezy, very young children.

Source: Pelkonen AS, Malmström K, Sarna S, Kajosaari M, Klemola T et al. The effect of montelukast on respiratory symptoms and lung function in wheezy infants. European Respiratory Journal. 2013; 41(3): 664-670.

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Being overweight increases susceptibility to indoor pollutants among urban children with asthma

This study from Johns Hopkins School of Medicine (Baltimore, Maryland, USA) included 148 children (age, 5-17 years) with persistent asthma that were followed for 1 year. Participants were predominantly African American (91%) and had public health insurance (85%); 16% were overweight, and 28% were obese.

Overweight or obese participants had more symptoms associated with exposure to fine particulate matter measuring less than 2.5 µm in diameter (PM[2.5]) than normal-weight participants. They also had more asthma symptoms associated with nitrogen dioxide (NO[2]) exposure.

However, there was no relationship with coarse particulate matter (2.5 and 10 ?m) and health care use, lung function, or pulmonary inflammation.

Being overweight or obese can increase susceptibility to indoor PM(2.5) and NO(2) in urban children with asthma.

Interventions aimed at weight loss might reduce asthma symptom responses to PM(2.5) and NO(2). Reducing indoor pollutant levels might be beneficial in overweight children. However, the effect of these measures on lung function is not clear from this study.

Source: Lu KD, Breysse PN, Diette GB, Curtin-Brosnan J, Aloe C et al. Being overweight increases susceptibility to indoor pollutants among urban children with asthma. Journal of Allergy and Clinical Immunology. 2013; Corrected proof; published online before print. doi:10.1016/j.jaci.2012.12.1570)

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Last updated: Tuesday, April 23rd, 2013