Dyspnoea in the Elderly: a Clinical Approach to Diagnosis

Overview

Journal Drugs Aging

Specialties Geriatrics
Pharmacology

Date 2001 Apr 17

PMID 11302285

Citations 2

Authors

J C Yernault

Affiliations

Soon will be listed here.

Abstract

This review briefly overviews the pathophysiology of dyspnoea and then focuses on discussion of the most frequent causes of chronic and acute dyspnoea in the elderly. The most common causes of dyspnoea in the elderly include heart failure, chronic obstructive pulmonary disease and asthma. Other causes include parenchymal lung disease, pulmonary vascular diseases, upper airway obstruction and pneumonia. Dyspnoea should not be attributed to aging alone. Careful clinical evaluation and spirometry is indicated, and additional testing may be appropriate. In this article, emphasis is placed on the clinical manifestations of dyspnoea in the elderly and an approach to their differential diagnosis is provided. Discussion of available therapy is beyond the scope of this article.

Citing Articles

Giant liver tumor causing dyspnea upon exertion.

Machairas N, Garoufalia Z, Sotiropoulos G Clin Case Rep. 2018; 6(7):1375-1376.

PMID: 29988632 PMC: 6028442. DOI: 10.1002/ccr3.1586.

Breathlessness in hospitalised adult patients.

Rao A, Gray D Postgrad Med J. 2004; 79(938):681-5.

PMID: 14707242 PMC: 1742884.

References

Jolobe O . Re: Asthma in the elderly: underperceived, underdiagnosed, and undertreated; a community survey. Respir Med. 1999; 93(2):146. View

Diggory P, Heyworth P, Chau G, McKenzie S, Sharma A . Unsuspected bronchospasm in association with topical timolol--a common problem in elderly people: can we easily identify those affected and do cardioselective agents lead to improvement?. Age Ageing. 1994; 23(1):17-21. DOI: 10.1093/ageing/23.1.17. View

Cook D, Simel D . The Rational Clinical Examination. Does this patient have abnormal central venous pressure?. JAMA. 1996; 275(8):630-4. View

Venkatesan P, Gladman J, Macfarlane J, Barer D, Berman P, Kinnear W . A hospital study of community acquired pneumonia in the elderly. Thorax. 1990; 45(4):254-8. PMC: 473766. DOI: 10.1136/thx.45.4.254. View

Landahl S, Steen B, Svanborg A . Dyspnea in 70-year-old people. Acta Med Scand. 1980; 207(3):225-30. DOI: 10.1111/j.0954-6820.1980.tb09710.x. View

Morris M . Difficulties with diagnosing asthma in the elderly. Chest. 1999; 116(3):591-3. DOI: 10.1378/chest.116.3.591. View

Sjostrom L, Larsson B, Backman L, Bengtsson C, Bouchard C, Dahlgren S . Swedish obese subjects (SOS). Recruitment for an intervention study and a selected description of the obese state. Int J Obes Relat Metab Disord. 1992; 16(6):465-79. View

Mahler D, Harver A, Lentine T, Scott J, Beck K, Schwartzstein R . Descriptors of breathlessness in cardiorespiratory diseases. Am J Respir Crit Care Med. 1996; 154(5):1357-63. DOI: 10.1164/ajrccm.154.5.8912748. View

. American Thoracic Society. Idiopathic pulmonary fibrosis: diagnosis and treatment. International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS). Am J Respir Crit Care Med. 2000; 161(2 Pt 1):646-64. DOI: 10.1164/ajrccm.161.2.ats3-00. View

10.

Simon P, Schwartzstein R, Weiss J, FENCL V, TEGHTSOONIAN M, Weinberger S . Distinguishable types of dyspnea in patients with shortness of breath. Am Rev Respir Dis. 1990; 142(5):1009-14. DOI: 10.1164/ajrccm/142.5.1009. View

11.

McGavin C, Artvinli M, Naoe H, McHARDY G . Dyspnoea, disability, and distance walked: comparison of estimates of exercise performance in respiratory disease. Br Med J. 1978; 2(6132):241-3. PMC: 1606354. DOI: 10.1136/bmj.2.6132.241. View

12.

Enright P, Kronmal R, Higgins M, Schenker M, Haponik E . Prevalence and correlates of respiratory symptoms and disease in the elderly. Cardiovascular Health Study. Chest. 1994; 106(3):827-34. DOI: 10.1378/chest.106.3.827. View

13.

Harper C, Newton P . Clinical aspects of pneumonia in the elderly veteran. J Am Geriatr Soc. 1989; 37(9):867-72. DOI: 10.1111/j.1532-5415.1989.tb02268.x. View

14.

Guyatt G, BERMAN L, Townsend M, Pugsley S, Chambers L . A measure of quality of life for clinical trials in chronic lung disease. Thorax. 1987; 42(10):773-8. PMC: 460950. DOI: 10.1136/thx.42.10.773. View

15.

Noseda A, Yernault J . [Quantifying dyspnea]. Presse Med. 1994; 23(33):1527-32. View

16.

Niset G, Ninane V, Antoine M, Yernault J . Respiratory dysfunction in congestive heart failure: correction after heart transplantation. Eur Respir J. 1993; 6(8):1197-201. View

17.

Smoller J, Pollack M, Otto M, Rosenbaum J, Kradin R . Panic anxiety, dyspnea, and respiratory disease. Theoretical and clinical considerations. Am J Respir Crit Care Med. 1996; 154(1):6-17. DOI: 10.1164/ajrccm.154.1.8680700. View

18.

Pride N, Vermeire P, Allegra L . Diagnostic labels applied to model case histories of chronic airflow obstruction. Responses to a questionnaire in 11 North American and Western European countries. Eur Respir J. 1989; 2(8):702-9. View

19.

ODonohue Jr W . Home oxygen therapy. Clin Chest Med. 1997; 18(3):535-45. DOI: 10.1016/s0272-5231(05)70400-7. View

20.

Borg G . Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14(5):377-81. View