AIM OF STUDY: To assess the relationships between age, respiratory symptoms, airways calibre and nonspecific bronchial responsiveness in a population sample including large numbers of elderly adults. RESULTS: 783 questionnaires were sent to eligible subjects. 395 subjects were invited to attend; 247 did so, of whom 246 performed spirometry and 208 completed bronchial challenge. Prevalence of smoking was high (29.2% current smokers, 37.3% ex-smokers). Asthma was reported by 7.3%, bronchitis by 15.4%; a further 7.3% reported both diagnoses. 53.8% of subjects reported one or more respiratory symptoms. Chronic airflow obstruction (defined as FEV₁/FVC<60% for age <65 years; for age ≥65 lower limit of FEV₁/FVC was calculated from reference ranges [Enright PD et al, Am Rev Respir Dis 1993; 147: 125-331]) was present in 26.4% of the population; bronchial hyper-responsiveness (PD₂₀<100μg) was found in 26.0%. Comparison with values calculated from reference ranges suggested that FEV₁ in non-smoking Manchester adults was lower than predicted. Only 55.4% of those with chronic airflow obstruction reported a diagnosis of asthma or bronchitis, and only 35.4% were using appropriate inhaled medications. There was no difference in the prevalence of reported symptoms, diagnoses, or chronic airflow obstruction between adults aged <65 or ≥65 years. Multiple regression analysis with bronchial responsiveness (log dose-response slope) as the dependent variable showed an independent negative relationship with FEV₁, and positive relationships with age and total IgE level. CONCLUSIONS: Respiratory morbidity is common in this middle-aged and elderly inner-city population, but is frequently undiagnosed and untreated. There is a positive relationship between bronchial responsiveness and age. Atopy is associated with bronchial responsiveness even in older adults.