Older adults living with asthma may face a hidden burden that has little to do with airway inflammation: the stigma of carrying a disease that others misjudge. A new scoping review published in BMC Public Health suggests that health-related stigma is a common experience for people with asthma, shaping how they use medication, how they see themselves, and how they engage with care, yet the specific experiences of older adults remain strikingly under-researched. The review, led by Austin Swamy and colleagues, followed the Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines.
The team systematically searched six databases, Medline OVID, Embase, Emcare, PsycInfo, Scopus and CINAHL, for empirical studies examining stigma in asthma, with a particular focus on older adults. This was supplemented by a grey literature search using Google. Titles and abstracts were screened independently by two authors, followed by full-text review and data extraction with a customised template.
The researchers treated stigma and ageism as sensitising concepts, synthesising findings narratively rather than statistically. Eighteen empirical studies spanning diverse cultural contexts, along with two reviews, met the inclusion criteria. Across this body of work, stigma emerged as a recurring theme, reported most often by people with severe asthma or frequent symptoms.
The authors organised the reported experiences into four key domains. Effective pharmacological treatments exist, yet poor adherence remains common, particularly the overuse of short-acting beta2-agonists (SABA) reliever inhalers and the underuse of inhaled corticosteroids that control underlying inflammation. The review frames stigma as influencing asthma management across emotional, behavioural and social domains, with downstream effects on adherence, wellbeing and healthcare engagement.
Age is where the review identifies its most significant gap. Although the review focused on later-life asthma, few of the included studies explicitly examined the experiences of older adults. The authors argue that age-related factors may interact with stigma in distinct ways: living with multiple chronic conditions, generational attitudes toward illness and disclosure, and historical experiences of how asthma was perceived and treated in earlier decades.
Cultural background, age-related biases and gender were acknowledged in some of the included studies, but the review found they were rarely analysed in depth. The review's conclusions carry practical implications for health promotion and self-management support. The authors call for age-specific, intersectional research to fill the evidence gap and for tailored interventions designed to reduce stigma-related barriers to care.
As a scoping review, the work maps what has been studied rather than testing interventions or measuring effect sizes, and its conclusions rest on the quality and scope of the eighteen included studies and two reviews.
Subject of Research: Health-related stigma and its impact on asthma self-management in older adults
Article Title: Understanding stigma in later life asthma: a mixed methods scoping review with an intersectional lens
Article References: Swamy, A., Madawala, S., Dharmawan, E., & Barton, C. (2026). Understanding stigma in later life asthma: a mixed methods scoping review with an intersectional lens. BMC Public Health. https://doi.org/10.1186/s12889-026-29684-0
Image Credits: AI Generated
DOI: 10.1186/s12889-026-29684-0
Keywords: asthma, stigma, older adults, scoping review, medication adherence, ageism, intersectionality, inhaled corticosteroids, SABA overuse, self-management, BMC Public Health, Understanding
News Source: Ophelia Keating. (October 28, 2026). Asthma Stigma in Older Adults Remains Largely Unstudied, Review Finds. Scienmag.
