Comparative Clinical Presentation of Bronchial Asthma in Adults and Children in North India

Background Asthma is a chronic inflammatory airway disease with heterogeneous clinical expression influenced by age of onset, atopy, and environmental exposures. Age-related variations in symptoms, exacerbation history, asthma control, and lung function may affect treatment. Objective The primary objective of this study was to compare the clinical, allergic, and spirometric characteristics between pediatric and adult patients with asthma. The secondary objective was to evaluate asthma control status and related factors in both groups. Methods In our cross-sectional study, we enrolled 96 children (6-12 years) and 136 adolescents and adults (13-65 years) diagnosed with bronchial asthma via consecutive sampling in a tertiary care setting. Their diagnosis was based on the Global Initiative for Asthma (GINA) criteria and spirometric reversibility. Demographic details, comorbidities, trigger exposures, family history and atopy history, and asthma control (GINA Asthma Symptom Control Test) were recorded. Clinically stable patients with no current respiratory infection were included, while those with major chronic respiratory conditions, cardiac illness, or malignancy were excluded. Spirometry parameters were also compared between adult and pediatric patients. Spirometry was conducted by a trained technician (equipment: COSMED Spirometer, Rome, Italy) with proper calibration in accordance with the American Thoracic Society (ATS) guidelines. Results Allergic rhinitis was the most frequent comorbidity and was more common in asthmatic children than adults (62 (64.6%) vs 56 (41.2%)). Children had a higher prevalence of family history of asthma than in adults (43 (44.8%) vs 22 (16.2%)). Adults had greater exposure to smoking and biomass fuels and a higher proportion of late-onset asthma. Well-controlled asthma was observed in 26 (27.1%) children and 42 (30.9%) adults, while partly controlled asthma was almost similar in adults and in children (70 (51.5%) vs 43 (44.8%)). Adults demonstrated significantly lower predicted forced expiratory volume in one second (FEV₁%) and FEV₁/forced vital capacity (FVC) ratio than children (p < 0.0001), indicating more severe baseline airflow limitation. Conclusion Asthma shows distinct age-related differences in allergic comorbidity burden, exposure profiles, and lung function impairment. These findings support the need for tailored, age-specific management strategies to improve asthma control across the life course perspective.