Inhalation therapy plays a central role in the pharmacological treatment of both chronic obstructive pulmonary disease (COPD) and asthma. Appropriate selection of inhaler devices and accurate mastery of inhalation techniques are essential for maximizing therapeutic efficacy. Advanced age is considered a major risk factor for difficulties in learning inhalation techniques, and patients with COPD commonly exhibit higher-order cognitive dysfunction. In Japan, the number of older individuals with dementia is increasing owing to population aging, making the provision of effective inhalation instructions for older adults an urgent issue. This retrospective study investigated the relationship between cognitive function and the degree of mastery of inhalation techniques in older patients, as assessed using the Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). Overall, FAB scores were more strongly associated with inhalation technique mastery than MMSE scores; indeed, patients with FAB scores of ≤12 had difficulty acquiring proper inhalation techniques. Dry powder inhalers that require manual capsule loading are difficult to master because of their operational complexity. The results of this study will help design effective strategies to improve inhalation technique and maximize therapeutic efficacy in older patients with COPD and asthma.
Yokoyama et al. (Thu,) studied this question.