ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH Parameters affecting inhalation therapy adherence in elderly patients with chronic obstructive lung disease and asthma Onur Turan, 1 Pakize Ayse Turan 2 and Arzu Mirici 3 1 Izmir Ataturk Training and Research Hospital, Chest Diseases Department, Izmir, 2 Canakkale State Hospital, and 3 Canakkale 18 Mart University, Chest Diseases Department, Canakkale, Turkey Aim: One of the most significant problems in the treatment of elderly patients is incorrect use of inhaler devices. The purpose of the present study was to assess the parameters affecting treatment adherence among elderly patients. Methods: Spirometry, the Mini-Mental State Examination for cognitive impairment and the Morisky Medication Adherence Scale-4 were carried out in 121 (88 chronic obstructive lung disease patients according to the Global Initiative for Chronic Obstructive Lung Disease, 33 asthma patients according to The Global Initiative for Asthma (GINA) criteria) participants aged over 65 years. Results: The patients with cognitive impairment, low socioeconomic status, a high number of admissions to an emergency service in past year and the presence of dyspnea or sputum had significantly lower inhalation device use scores (P = 0.017, 0.03, 0.025, 0.03 and 0.02). The patients with high Mini-Mental State Examination scores and forced expiratory volume in 1 s (as liter and percentage) were found to be more successful in using inhaler devices (P = 0.005, 0.007 and 0.022). There was a negative correlation between number of hospitalizations and inhalation device score (P = 0.021).The participants without education/training by a doctor about the inhaler device had a significantly poorer treatment adherence (P < 0.001). Conclusions: Older chronic obstructive lung disease and asthmatic patients have more difficulty with the correct use of inhaler devices. Cognitive impairment might be an important parameter that can affect inhalation device technique. Socioeconomic status, smoking, pulmonary symptoms and admissions to hospital were also thought to have effects on the adherence to inhalation therapy. The type of chronic respiratory disease (chronic obstructive lung disease/asthma) is not a major factor influencing therapy adherence. Assessment of cognitive functions, choosing suitable inhalation devices and educational programs for inhaler use could improve the success of inhaler technique in elderly patients. Geriatr Gerontol Int 2016; ••: ••–••. Keywords: adherence, cognitive functions, elderly, inhalation, patient education. Introductıon Chronic obstructive pulmonary disease (COPD) is defined as a progressive chronic disease of the respiratory system characterized by airflow obstruction. 1 As COPD is an age-related disease, it will become a major problem in the next few decades. 2 Prevalence surveys show that ap- proximately one-quarter of adults aged older than 40 years have airflow obstruction. 3 Increasing age is associated with increasing prevalence in COPD; the prevalence of COPD in patients aged older than 65 years was found to be nearly 1.5-fold more that of patients aged 40 years or older. 4 Asthma is a chronic inflammatory disorder of the airways characterized by reversible airway obstruction. Asthma might affect 9% of the USA population aged older than 65years, which shows that it is a common disease among older adults. 5 Like most of the chronic diseases, non-adherence to medical therapy is a major public health concern, and a sig- nificant risk factor for morbidity and mortality in chronic respiratory diseases. 6 It has been reported that nearly half of asthma or COPD patients had adherence to inhaled and oral medications. 5 Advanced age has been shown to be an important factor for poor adherence to medical ther- apies. 4 Improper and ineffective inhalation technique is a serious problem that can negatively affect the prognosis the elderly COPD and asthma patients. Cognitive Accepted for publication 7 April 2016. Correspondence: Dr Onur Turan, MD Izmir Ataturk Training and Research Hospital, Chest Diseases Department, 35150 Izmir, Turkey. Email: onurtura@yahoo.com This study won the first prize for the Oral Presentation about COPD at the 18th Annual Turkish Thoracic Society Congress in Antalya, Turkey 2015. © 2016 Japan Geriatrics Society doi: 10.1111/ggi.12823 | 1 Geriatr Gerontol Int 2016