Lifetime prevalence of self-reported atopic diseases in a population-based sample of elderly subjects:: results of the ESTHER study

Background: Prevalence studies of atopic diseases such as atopic dermatitis (AD), hay fever and allergic asthma have mostly been performed in children. Studies in the adult population are still rare. Objectives: We estimated the lifetime prevalence of different atopic diseases in an elderly population in Saarland, Germany. Additionally we investigated the association between atopic diseases and sociodemographic factors including age, gender, duration of school education (as a proxy measure of socioeconomic status), family history, and size of place of residence. Methods: This study was conducted between June 2000 and December 2002 in the State of Saarland, Germany. Participants aged 50-75 years (n = 9961) were recruited by their general practitioner in the context of a general health screening examination. All filled out a standardized questionnaire and reported whether a physician had ever diagnosed an atopic disease (hay fever, AD or asthma). Results: Overall, 9949 subjects (mean age 62 years, 45% men) were included in this analysis. The lifetime prevalence of reported AD, hay fever and asthma was 4.3%, 8.3% and 5.5%, respectively. Lifetime prevalence of AD and asthma among women, and lifetime prevalence of hay fever among both genders, strongly decreased with age. Duration of school education (<= 9 years, 10-11 years, > 11 years) was strongly associated with AD (3.7%, 5.7%, 6.8%; P trend < 0.0001) and hay fever (7.2%, 11.2%, 12.8%; P trend < 0.0001), but only tentatively with asthma. Conclusions: The lifetime prevalence of AD is considerably lower in the elderly compared with the prevalence reported among younger adults in recent studies. Adults with a longer duration of school education appeared to have a higher risk for atopic diseases.