How over 60s can better manage their asthma during colder months

As winter approaches, it brings with it a certain charm and cosiness, with nights by the fire and warm cups of cocoa. However, it can also spark fear in the 2.7 million Australians living with asthma, particularly those over the age of 60.

In simple terms, asthma is a chronic inflammatory disorder that causes the airways in the chest to narrow and results in worrying symptoms including wheezing, breathlessness and tightness in the chest.

For those over the age of 60, managing asthma during the winter months can be particularly challenging. The cold weather and dry air can trigger asthma symptoms, making it difficult to breathe and leading to potentially serious health complications. It is important for individuals in this age group to take extra precautions to manage their asthma during the winter months.

“There’s a high prevalence amongst older Australians with asthma,” Michele Goldman, CEO of Asthma Australia, tells Starts at 60.

“About 12 per cent, or one in eight Australians over 65 have asthma.”

How the cold weather affects your asthma

While there’s been plenty of research over the years to investigate what actually causes asthma and to find a potential cure, experts still don’t fully understand the underlying causes of the respiratory condition but do know that genetic, environmental and lifestyle factors can increase a person’s risk.

Because asthmatics have sensitive bronchial tubes, things like inhaling cold air can irritate these airways, leading to coughing, wheezing, and breathlessness. The winter season poses a higher risk of flare-ups for those with asthma, particularly in dry and windy conditions. The more severe asthma, the greater the chance of experiencing symptoms from cold air exposure.

Signs the cold weather has triggered your asthma

These symptoms are no different from asthma caused by other triggers, which include:

• Coughing, whether dry or with phlegm
• Wheezing, especially when breathing out
• Shortness of breath
• Tightness in your chest

“Just because your asthma is mild, it doesn’t mean you should underestimate its seriousness and you should be diligent in taking the steps you need to ensure you’re managing your asthma well,” Goldman says.

“20 per cent of all death from asthma are amongst people who have a mild form of the disease, so it can still be life-threatening.”

Factors that could cause your asthma to worsen during the winter season:

• Increased indoor allergens: As people spend more time indoors during the winter season, they may be exposed to indoor allergens such as dust mites, mould, and pet dander that can worsen asthma symptoms.
• Viral respiratory infections: The winter months in Australia coincide with the flu season, and respiratory infections caused by viruses such as the flu can lead to severe asthma attacks.
• Bushfires: Although bushfires are more common during the summer season in Australia, they can also occur during the winter months. Smoke and other pollutants from bushfires can trigger asthma symptoms.
• Thunderstorm asthma: Rare but potentially life-threatening, thunderstorm asthma occurs when certain weather conditions cause pollen grains to rupture and release tiny allergen particles into the air, triggering asthma symptoms in people who are sensitive to pollen.

How to handle asthma in the winter

While preventer medication is effective in reducing underlying inflammation in the airways, many people simply rely on their blue reliever medication and only treat symptoms with this when they’re feeling unwell by taking a few puffs of their reliever.

This type of medication is fast-acting, reduces muscle restriction and people can often feel a benefit straight away, but Goldman warns that it’s only a Band-Aid solution, that it doesn’t reduce underlying inflammation and the effect of the reliever wears off after a few hours.

“They just go around in this vicious cycle where they continue to have symptoms because of the underlying information and continue to put themselves at risk of a flare-up,” Goldman says.

“If you do have symptoms regularly, you should be talking to your doctor about whether you need a preventer medication because that will help keep your airways healthy and reduce your risk.”

Ways older adults can avoid asthma attacks in the cold

Try to stay indoors when the temperature dips very low, and if you do have to go outside, cover your nose and mouth with a scarf to warm the air before you breathe it in.

Here are a few other tips:

• Stay hydrated and drink extra fluids in the winter. This can help keep the mucus in your lungs thinner and easier for your body to remove.
• Vacuum and dust your home frequently to help remove indoor allergens that can trigger asthma symptoms.
• If you exercise outdoors in cold weather, warm up for at least 10 to 15 minutes before you work out, and consider using your inhaler 15 to 30 minutes before you exercise. It’s also a good idea to carry an inhaler with you in case you have an asthma attack.

What else should you know about winter and asthma?

Because asthma is a complex disease and varies from person to person, it’s always best to talk to a GP or pharmacist about which treatment is going to be most effective for individual circumstances.

Similarly, there are hundreds of different triggers including hay fever, pollen, smoke, bushfires, mould and the flu which can impact asthma sufferers in different ways. As such, it’s also important to set up an asthma action plan with a health professional.

Action plans help those with asthma recognise flare-ups or worsening symptoms and advise them on what to do when this happens. The plans are individual, written by a GP and include information about doses and frequencies of medication, how to adjust treatment in the event of an exacerbation, manage the severity of attacks, identify warning signs and how exactly to seek urgent medical help if needed.

“The best defence is an offence. We would encourage people to be on preventer medication if they have symptoms,” Goldman says.

“They should always carry their reliever medication on hand. People move around and smoke shifts, wind patterns change and the direction and concentration of pollen in the air might change, so you never know when you might have symptoms.”

It’s also important to regularly talk to a GP about whether you’re on the right preventer, that the dose of medication is still correct and that the asthma action plan is up-to-date.

This article was originally published on September 9, 2019, and has been updated on May 2, 2023.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.