Evaluation of dyspnea in the elderly patient

The symptom of dyspnea in the elderly person should not be considered part of the "normal aging process." Instead, the history, examination, and testing should focus on cardiac disease, respiratory disease, and deconditioning as the most likely causes. Because respiratory sensation is diminished with aging, breathlessness may not develop until a more advanced stage of disease or dysfunction. Clinical measurement of dyspnea is important to assess its severity and to evaluate response to treatment. Specific treatment should be directed toward the pathophysiology of the underlying disease. General strategies for relieving dyspnea include breathing techniques, exercise training and reconditioning, oxygen therapy, improved nutrition, and, in selective cases, psychotropic medication.