{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T04:21:44Z","timestamp":1778905304053,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T00:00:00Z","timestamp":1581984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Asthma is common in older adults and is confirmed by demonstration of variable expiratory air-flow limitations, typically evaluated by spirometric assessment of bronchodilator responsiveness. However, many patients with clinically suspected asthma and documented air-flow obstruction do not exhibit a post-bronchodilator response that meets or exceeds current established guidelines. We investigated if extending the time from bronchodilator administration to assessment of bronchodilator response increases the yield of spirometry for the diagnosis of asthma in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This was a cross-sectional study. The subjects were non-smokers, \u2265 60 y old, and with suspected asthma. Subjects were characterized as (1) those with a positive bronchodilator response on the 30-min post-bronchodilator spirometry, (2) those with a positive bronchodilator response on the 60-min post-bronchodilator spirometry, and (3) those without a positive bronchodilator response but with a positive methacholine challenge test. Factors associated with a late response to bronchodilator were evaluated by using bivariate analysis and by multivariate analysis by using a logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      This study enrolled 165 subjects. Of these, 81 (49.1%) had a positive bronchodilator response on 30-min post-bronchodilator spirometry; 25 (15.2%) had a positive bronchodilator response on the 1-h post-bronchodilator spirometry; and 59 (35.8%) had no positive bronchodilator response but had a positive methacholine challenge test. On multivariable regression analysis, those with a higher baseline percentage of predicted FEV\n                      <jats:sub>1<\/jats:sub>\n                      , higher scores on a standard asthma control test, and wheezing and\/or cough after exercise were more likely to either have a late bronchodilator response or no bronchodilator response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Our study showed that a late positive response to bronchodilator use was more common than previously presumed in older subjects with suspected asthma. Pulmonary function testing laboratories should consider routinely reassessing spirometry at 1 h after bronchodilator use if the earlier assessment did not reveal a significant response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.07132","type":"journal-article","created":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T13:35:44Z","timestamp":1582032944000},"page":"1104-1111","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Current Bronchodilator Responsiveness Criteria Underestimate Asthma in Older Adults"],"prefix":"10.1177","volume":"65","author":[{"given":"Rodrigo S","family":"Cavallazzi","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Critical Care Medicine, and Sleep Disorders University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara J","family":"Polivka","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Kansas, Kansas City, Kansas."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan L","family":"Beatty","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care Medicine, and Sleep Disorders University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Demetra E","family":"Antimisiaris","sequence":"additional","affiliation":[{"name":"Department of Health Management &amp; Systems Science, University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rangaraj K","family":"Gopalraj","sequence":"additional","affiliation":[{"name":"Norton Healthcare, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel A","family":"Vickers-Smith","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Louisville, Louisville, Kentucky."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodney J","family":"Folz","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine University Hospital Cleveland Medical Center and Case Western Reserve University."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,2,18]]},"reference":[{"key":"e_1_3_3_2_1","unstructured":"1. 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