LAUSR

We read with interest the recent study by Bozek et al reporting comorbidities in elderly patients with asthma and chronic obstructive pulmonary disease (COPD) [1]. They found that elderly patients with asthma frequently suffer from arterial hypertension and/or depression, and patients with COPD have a more exaggerated profile of coexisting diseases, especially cardiovascular problems. This study increases our understanding of comorbidities in the elderly population with asthma and COPD. Unfortunately, respiratory comorbidities, which are very common in asthma and COPD, have been neglected when the authors identified the various comorbidities. To extend our understanding of this issue, we have systematically reviewed literature in recent years and summarized respiratory comorbidities (other than asthma and COPD) in patients with asthma and COPD (Table 1). For example, it is noticeable that allergic rhinitis and chronic rhinosinusitis are the most common coexistent respiratory diseases in asthma [2]. A recent study involving subjects aged 65 years with asthma also showed that approximately 60% of them had rhinitis [3]. This proportion is sufficiently large to be taken into consideration. Identifying and managing respiratory comorbidities such as rhinosinusitis, sinusitis, and nasal polyps are emphasized even in the Global Initiative for Asthma (GINA) 2016 report [4], which indicates that these comorbidities may contribute to symptom burden, impaired quality of life, and medication interactions in asthma.Moreover, asthma andCOPD can coexist with sleep breathing disorders like obstructive sleep apnea syndrome [3,5]. Sleep apnea has been found, by polysomnography, in 65.9% of patients with moderate to severe COPD [6]. Lung cancer is thought to be themost frequent cause of death in patients with mild to moderate COPD. Other respiratory diseases such as acute bronchitis pneumonia are also common in older age groups [7]. The collective findings indicate that respiratory comorbidities are both common in asthma and COPD and, therefore, should not be neglected or underestimated.