A wheezing woman blows her nose.

I t’s often assumed that allergies and asthma are problems of youth. But both can continue well into your later years or crop up for the first time, and some research suggests that the percentage of older adults with these conditions is rising.

“It’s not uncommon to develop seasonal or indoor allergies later in life,” says Janna Tuck, M.D., spokeswoman for the American College of Allergy, Asthma & Immunology.

But it’s not always easy to know whether you’re experiencing allergies, asthma, or an unrelated problem. And managing allergies and asthma as we age has its particular challenges.

Whether you’ve been coping with one or both for years or you’re just noticing new symptoms and are unclear about what’s going on, here’s what you need to know and do.

Allergies or Aging?

In some cases, symptoms resembling ­allergies could be caused by something else. For instance, postmenopausal women may have more nasal dryness, which can be mistaken for an allergy symptom.  

More on Allergies

Certain medications for conditions we associate with advancing years—such as those for high blood pressure and heart disease—can cause or exacerbate congestion or difficulty breathing.

“Other common issues of aging, like congestive heart failure or COPD (chronic obstructive pulmonary disease), can mask or mimic allergies and asthma,” says Linda Ford, M.D., founder and medical director of The Asthma & Allergy Center in Bellevue, Neb. “That can lead to a misdiagnosis or difficulties in diagnosing and treating older adults.”

What to do: Report your symptoms to your doctor­—even if they seem unrelated—and go over your medications (include over-the-counter drugs and supplements). He or she can help determine the cause. 

Allergen vs. Irritant

Nonallergic rhinitis (an allergylike reaction to substances you’re not allergic to) is more frequent with age.

“Nonallergic rhinitis is quite common in older adults, but it’s often mistaken for allergies or a cold because the symptoms are very similar,” Tuck says. For example, you may suddenly become congested, have a runny nose, or sneeze when you sit near a smoker or walk down the detergent aisle. Cold, dry air and food (especially spicy items) can set off similar symptoms.

What to do: Be aware that the symptoms above occur with allergies and non­allergic rhinitis, but allergies can also cause itchy eyes and throat. If you’re unsure what’s causing discomfort, keep a diary of symptoms and what triggers them, to see whether a pattern emerges.

And keep your nasal passages well-hydrated. If the air in your home is dry, consider using a humidifier to maintain indoor air at between 30 and 50 percent humidity; this can also help prevent the growth of allergens such as mold and dust mites.

Identifying Asthma

Many people with asthma have allergic asthma, Ford says, which means allergens in the environment can set off an episode. As you get older, exposure to allergens (or pollutants) can lead to more severe asthma or a first-time attack.

“Triggers that may not have bothered you when you were younger may cause asthma symptoms now,” says Jay Portnoy, M.D., of the division of allergy, asthma, and immunology at Children’s Mercy Kansas City in Missouri. Older adults also appear to be much more likely to be hospitalized or die from asthma than younger adults.

What to do: Tell your primary care doctor if you notice possible asthma signs, such as a lingering cough, a wheezing sound when you breathe, and periods of shortness of breath.

“Any time you’re short of breath, persistently or intermittently, you should see a doctor,” says Norman Edelman, M.D., senior science adviser for the American Lung Association.

Pinpointing asthma can be challenging. “Older adults may have other causes of wheezing and cough—such as COPD, heart disease, gastrointestinal reflux, or sinus disease,” Ford says.

Be Savvy About Treatment

If your allergy (or nonallergic rhinitis) symptoms are mild or only occasional, you can probably simply minimize expo­sure to triggers and use OTC steroid nasal sprays such as fluticasone (Flonase ­Allergy Relief) and triamcinolone (Nasacort Allergy 24 HR) once in a while.

But if your symptoms affect your quality of life “or you’re having trouble distinguishing whether it’s a cold, allergies, nonallergic rhinitis, or asthma—an allergist can help parse the symptoms and make a diagnosis,” Tuck says.

In addition to taking a full medical history, including information on when symptoms occur, your doctor may recommend a skin or blood test to help identify triggers. “This information is particularly helpful in the case of indoor allergens, where, if you know what you’re allergic to, you can take action to reduce your exposure,” Portnoy says.

If you and your doctor determine that you need more than occasional medication for relief, 2017 treatment guidelines emphasize steroid nasal sprays rather than oral antihistamines, says Portnoy, a co-author of the guidelines. “The latest research shows these are more effective, with fewer side effects, making them a safer option for older adults,” he says.

The guidelines note that oral antihistamines aren’t as helpful, even for moderate to severe allergies.

Tuck recommends that older adults avoid or limit the use of medication with the OTC antihistamine diphenhydramine (Benadryl Allergy and generic).

“It can have hangover effects, particularly as your metab­o­lism decreases with age. Even if you are no longer feeling sleepy, it can still affect cognitive function, reaction time, and decision-making the morning after,” she says.

The newer OTC antihistamines, which include loratadine (Claritin and generic), cetirizine (Zyrtec and generic), and others, can cause drowsiness, too.

“Older adults don’t metabolize drugs as quickly, so I often recommend using child formulas and dosages to reduce the risk of side effects like sleepiness,” Ford says.

For asthma at any age, the first line of daily preventive treatment is an inhaled corticosteroid (Flovent, Pulmicort, and others) to keep airway and lung inflammation and mucus buildup at bay. (Certain preventive drugs combine a steroid and a bronchodilator.) A fast-acting ­inhaler with albuterol (Proventil, Ventolin, and others) is used for acute asthma symptoms. Albuterol, a bronchodilator, relaxes airway muscles and increases airflow during an asthma ­attack.

For moderate to severe allergic asthma, your doctor may recommend an injectable preventive drug such as benralizumab (Fasenra), mepolizumab (Nucala), or omalizumab (Xolair), which helps prevent and reduce the frequency of asthma episodes.

Older adults might be less responsive to the usual asthma treatments, so if you aren’t getting relief from your current regimen, talk with your doctor. And if you—or someone around you—experiences a severe asthma attack and is having difficulty breathing, call 911 or seek emergency medical help immediately.

Reducing Allergens at Home

Allergies got you down? On the "Consumer 101" TV show, Consumer Reports experts explain how to reduce dust mites and other triggers in your home.

Editor’s Note: This article also appeared in the April 2018 issue of Consumer Reports On Health