Summary
We studied the ability to learn metered dose
inhaler (MDI) and Turbohaler* techniques in 30
inhaler-naive elderly subjects with normal,
borderline or abnormal scores on the abbreviated
mental test (AMT)(10 in each group). All of those with
a normal AMT (>7) were able to learn the Turbohaler
technique and 8/10 reached a competent MDI
standard. None of those with an abnormal AMT (<7)
was able to learn the MDI method and only 3/10
could master the Turbohaler. However, of those with
a borderline AMT of 7 only 2/10 learned the MDI
method while 9/10 were able to use the Turbohaler
(p<0.05). In a parallel study of 16 elderly patients
with asthma or COPD and normal AMT scores we
showed that the Turbohaler technique was generally
better retained than the MDI method at follow up.
Furthermore, in a group of seven elderly asthmatic
subjects with an AMT of 6 or 7 (mild or borderline
impairment) who were unable to use an MDI, all were
able to learn to use the Turbohaler with standard
training and reinforcement , four retained an
adequate technique on follow up and a further two
improved with additional training. We have
demonstrated that the Turbohaler is a suitable choice
of inhaler device for elderly patients with a normal
or mildly impaired AMT score.
Keywords: elderly, inhaler, asthma, cognitive
function
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