There are significant age-related distinctions in asthma characteristics in children, highlighting the need for precise age categorization in clinical guidelines which can help improve the personalized management approaches.

Using a large English data set, this study sought to examine the effect of age on characteristics, treatment, and exacerbations of asthma in adolescents and younger children.

From 2004 to 2021, the primary care medical records were connected with hospital records. A total of 1,19,611 eligible children were described by age at the time of diagnosis (as per the management guidelines) and primarily divided into three age groups:

• 5 to 8 years - 61940 children (51.8%)
• 9 to 11 years - 32316 children (27.7%)
• Adolescents 12 to 16 years - 25355 children (21.2%)

Examined characteristics encompassed body mass index (BMI), allergic reactions, and pre- and post-diagnosis events (symptoms and treatment options). Incidence of exacerbations (asthma attacks) was deliberated, and multivariable Cox proportional hazards were used to recognize the links with the attacks.

As found, many traits varied by age: pediatrics aged 5 to 8 years exhibited the highest proportion of cough, eczema (dermatitis), and food/drug allergy. On the other hand, adolescents illustrated the highest proportion of overweight and obesity, sensitization to aeroallergen, shortness of breath (dyspnea), and short-acting-beta-agonist only use. The exacerbation rates are described in the following Table 1:

Risk factors for exacerbation varied with age; in younger children (5 to 8 years’ group), strong links were found with male gender, eczema, and food or drug allergy, whereas for children aged ≥9 years, obesity and sensitivity to aeroallergens had a strong association.

Of note, greater socioeconomic deprivation was considerably linked with having an exacerbation for all the children. The highest incidence of late diagnosis occurred in younger children, and this was linked to an elevated rate of exacerbations among all the age groups.

The baseline characteristics and rates of exacerbation in children differed based on their age groups. It is suggested that clinical guidelines define age categorization at the time of diagnosis beyond the 5 to 16 years range, as it seems to impact the severity of asthma and management options.