Asthma has shifted from an anciently recognized malady to a dynamic global health concern whose burden varies sharply by country, income level, age and generation. After post-war surges, prevalence in many high-income nations has plateaued or fallen, while rapidly urbanizing low- and middle-income countries are still climbing. Heterogeneity is striking: wheeze rates in European preschoolers span 10 % in Greece to 55 % in Spain, and only 30–40 % of recurrent early wheeze progresses to school-age asthma. Gene–environment interactions—viral infections, atopy, parental smoking, caesarean delivery—drive persistence, while better treatment has cut childhood mortality even as incidence inches up. Key risks remain parental asthma, socioeconomic deprivation and urban air pollutants such as NO₂ and PM2.5.
Patterns fragment further after puberty. Global adolescent prevalence has levelled overall, yet wide regional gaps persist and a sex flip emerges: boys dominate in childhood, post-pubertal asthma is more common—and remits less often—in females, likely due to hormonal effects on airway reactivity. In young adults, prevalence is declining in high-SDI countries, but adult-onset, often non-allergic asthma carries a poorer prognosis, linked to obesity, hormones, stress and workplace exposures (≈16 % of new cases). After 55, crude prevalence rises again; age-related lung changes and infection-triggered late-onset disease make asthma more severe and frequently under-diagnosed. These shifting patterns underscore the need for continuous, high-quality surveillance to guide prevention and personalized care across the life-course.
Reference: Miligkos M, Oh J, Kwon R, et al. Epidemiology of asthma across the ages. Ann Allergy Asthma Immunol. 2025 Apr;134(4):376-384.e13. doi: 10.1016/j.anai.2024.12.004. Epub 2024 Dec 12. PMID: 39674277.
