Is It Allergies — or Adult-Onset Asthma?

How to tell the difference between these common conditions — plus tips for talking with your doctor

Bobbi Dempsey,

AARP

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Published February 20, 2026

abstract medical illustration of human lungs and the bronchial tree set against a vibrant magenta background with soft, floating shapes representing allergens or irritants

Ran Zheng

If you have been experiencing respiratory symptoms like coughing, wheezing or difficulty breathing, you might be surprised to learn that asthma could be the cause — even if you were never diagnosed with this condition in the past.

Allergies and common illnesses — like the flu, COVID or the common cold — are often blamed for breathing problems, but adults can develop asthma too, including those in their 50s, 60s and beyond.

What is adult-onset asthma?

As you can probably guess from the name, adult-onset asthma is a type of asthma in which the symptoms don’t appear until well into adulthood.

“Adult-onset asthma is more common than many people realize, particularly among older adults,” says Dr. Ramon Tallaj, an internist and founder and chair of SOMOS Community Care. “It can develop without a childhood history and is often associated with cumulative environmental exposure, chronic airway inflammation, respiratory infections, obesity or other medical conditions.”

In some cases, asthma can develop in childhood but may go “dormant” and cause few symptoms — or none at all — until the condition flares up again later in life, says Dr. Mauli Desai, an associate professor of medicine in the division of Allergy and Immunology at the Albert Einstein College of Medicine.

What’s more, asthma in adults can be triggered by exercise, pet dander, mold and exposure to irritants like smoke and perfume, says Desai, who is also codirector at Montefiore Medical Center.

An underdiagnosed condition

Adult-onset asthma is often overlooked, in part because people assume asthma is something that is diagnosed during childhood. Another reason: Its symptoms are similar to those caused by other medical conditions that affect the heart and lungs, Tallaj says.

“Early identification in the primary care setting is critical, especially in underserved communities where routine care may be delayed,” he says.

Symptoms of adult-onset asthma

Asthma causes a variety of respiratory symptoms, including:

Cough
Shortness of breath
Chest tightness
Wheezing

Desai notes that similar symptoms can be caused by other serious health conditions, such as chronic obstructive pulmonary disease (COPD) or heart conditions, which also require medical treatment. Therefore, it is important to consult with your physician whenever you develop sudden respiratory symptoms.

The difference between asthma and allergies

Asthma symptoms can look like those caused by allergies, so it’s important to pay particular attention to the severity of your symptoms and any patterns you may notice when they occur.

“Key warning signs include persistent shortness of breath, chest tightness, wheezing and recurrent coughing, especially at night, with exertion or after respiratory infections,” Tallaj says. “Unlike allergies alone, asthma symptoms tend to recur and fluctuate in intensity and often improve with bronchodilator therapy,” such as an inhaler.

How adult-onset asthma is diagnosed

No matter when it occurs, diagnosing asthma typically involves several steps, including a detailed medical history that includes tracking symptoms and identifying any noticeable patterns and triggers. Your doctor may also order tests to evaluate your lung function.

The goal of this testing is often twofold: confirming a suspected asthma diagnosis while also ruling out (or detecting) other possible causes of respiratory symptoms.

Talking to your doctor about adult-onset asthma

If you recognize any of the symptoms listed above, consult your doctor as soon as possible. Information to share with your doctor includes:

Frequency and severity of symptoms.
Any patterns you’ve noticed about when they occur or possible triggers.
Environmental conditions that may be relevant, such as any pets in your home or the possible exposure to mold or other pollutants.
Other health conditions you have that may cause similar symptoms or make asthma symptoms worse.

It’s also a good idea to ask your doctor for recommendations on safe exercise strategies. Also, mention any new or worsening symptoms that would be cause for concern.

Your primary care doctor may refer you to a pulmonologist or other specialist for a consultation or a more in-depth evaluation.

Treatment for adult-onset asthma

Treatment options for asthma may depend on symptom frequency and severity, but a common approach involves inhaled anti-inflammatory medications combined with rescue bronchodilators. In some cases, Desai says, your doctor may suggest injectable therapies (biologics) if inhalers alone do not control your asthma symptoms.

Regular physical activity, based on the individual’s capabilities and medical circumstances, can improve functional capacity and reduce breathlessness. Breathing exercises may also help with some symptoms.

At the same time, Desai says, your doctor will want to identify and manage any coexisting conditions, such as sinusitis, nasal polyps or gastroesophageal reflux disease (GERD), that can worsen asthma or make it more difficult to control.

Special considerations for older adults

Asthma is a serious health condition at any age, but older adults often have specific circumstances that can make severe symptoms or added complications more likely. “Older adults may face increased risks due to symptom overlap with heart disease, COPD and other chronic illnesses,” Tallaj says.

Treatment plans for older adults with asthma must consider any other chronic health conditions or medications the person may already be taking. Older adults are also more likely to have reduced lung elasticity, which can make managing asthma more challenging.

Desai says older adults may struggle to use an inhaler properly because of conditions such as arthritis or difficulty taking a deep breath. She advises anyone who is having difficulty using an inhaler to talk to their doctor, who may be able to recommend a different type of inhaler that would be easier to use.

Doctors stress that older adults shouldn’t ignore any type of respiratory issues, including those possibly caused by asthma.

“Asthma hospitalization rates are significantly higher in older adults, and adults over 65 have the highest mortality rates from asthma,” Desai says. “It is very important to identify symptoms of asthma early, get a prompt diagnosis and come up with a treatment plan with your doctor.”

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Bobbi Dempsey is a freelance writer who has written about a variety of topics, including health and entertainment, for aarp.org and AARP The Magazine. Her work has also appeared in Parade, The New York Times, Harper’s Magazine and other outlets.