Shortness of Breath in Older People - Causes. Symptoms, and Treatment

Introduction:

Shortness of breath or dyspnea refers to a condition that occurs due to the difficulty in the inflow of air into the lungs. It is common among people above 65 years of age. It usually occurs as a symptom of heart and lung problems. But it can also occur due to conditions, like anxiety, asthma, or allergies.

Shortness of breath is broadly classified into:

1. Acute Dyspnea: It occurs suddenly and lasts for a short period, such as hours to a few days. The conditions that cause acute dyspnea are allergies, anxiety, exercise, common cold, and flu. Serious conditions like heart attack, anaphylaxis (an allergic reaction which occurs with sudden onset in response to specific food, medications or venom), and pulmonary embolism can also cause acute dyspnea.

2. Chronic Dyspnea: The shortness of breath which occurs for a long period is known as chronic dyspnea. Asthma, chronic obstructive pulmonary disorder (COPD), and heart failure can lead to chronic dyspnea.

What Are the Types of Shortness of Breath?

• Sleep Apnea: It is a sleep disorder which causes breathing to start and stop continuously. This prevents the body from receiving sufficient oxygen. Patients with sleep apnea suffer from feelings of breathlessness.

• Orthopnea: It refers to a type of shortness of breath that occurs while lying down. Orthopnea can be a sign of heart failure.

• Paroxysmal Nocturnal Dyspnea: It is a condition where a person experiences shortness of breath and coughing, especially while sleeping during night times. It causes the person to wake up after a few hours due to suffocation. The main cause of paroxysmal nocturnal dyspnea is left ventricle failure.

• Hyperventilation: Hyperventilation refers to quick, shallow breathing, which leads to the disruption in balance between inhaling oxygen and exhaling carbon dioxide. The main causes of hyperventilation are anxiety, panic attacks, or stress.

• Hypoventilation: It is a medical condition that causes slow and ineffective breathing. This leads to a lack of oxygen and increased carbon dioxide in the blood.

What Are the Causes of Shortness of Breath in Older People?

Shortness of breath or dyspnea occurs in older people due to numerous reasons, which include:

• Chronic Obstructive Pulmonary Disorder (COPD): COPD is considered one of the most common conditions that causes shortness of breath. It is the combination of two different diseases, such as chronic bronchitis and emphysema. COPD progressively damages the lungs, which results in breathing difficulties.

• Pulmonary Embolism: It is also a common cause of shortness of breath in older people. Pulmonary embolism occurs when a blood clot migrates to the lungs, which leads to trouble in breathing.

• Atelectasis: It is a condition that causes the collapse of the lungs, leading to the reduced exchange of gas. Atelectasis is a serious cause of shortness of breath.

• Congestive Heart Failure: It is a serious condition that occurs when the efficiency of the heart to pump blood gets severely affected. It is a chronic condition that results in the collection of blood and fluids in the legs and lungs. Congestive heart failure over time can cause shortness of breath.

• Heart Attack: During a heart attack, the person experiences tightness in the chest and difficulty in breathing.

• Anemia: Anemia or a decrease in red blood cells reduces the amount of oxygen in the body, and this makes breathing difficult.

• Anxiety: Anxiety or panic attacks can alter the heart rate, which in turn causes shortness of breath. This makes the person breathe faster resulting in hyperventilation.

• Asthma: It is a medical condition that occurs due to inflammation and obstruction of the airway or lungs. Shortness of breath is an important symptom presented by asthma patients.

What Are the Clinical Manifestations of Shortness of Breath in Older People?

Older people with shortness of breath experience the following signs and symptoms:

• Chest tightness.

• Rapid breathing.

• Increased heart rate.

• The feeling of suffocation.

• Wheezing.

• Trouble in inhaling and exhaling.

• Chest pain.

How Is Shortness of Breath Diagnosed?

Following are the methods to diagnose shortness of breath in older people:

1. Non-invasive Cardiopulmonary Exercise Testing: In this test, a patient is made to run on a treadmill or cycle on a stationary bike. The amount of oxygen utilized by the body and lung and heart functions are analyzed by this test. It is the gold standard to diagnose the exact cause of dyspnea or shortness of breath.

2. Electrocardiogram (ECG): In ECG, the electrical activity of the heart is assessed by attaching electrodes to the chest. ECG can determine the cardiac causes of shortness of breath.

3. Chest X-ray: X-rays of the chest are taken to check for any blockages or abnormalities in the chest that might be responsible for the shortness of breath.

4. Lung Function Tests: This helps understand how well the lungs are functioning and the breathing efficiency.

5. Blood Test: Blood tests are advised to check for anemia (low red blood cell count) or other illness.

How Is Shortness of Breath Treated in Older People?

Following are the treatments recommended for older people with shortness of breath:

• Exercise: Regular exercise helps in improving the strength of the heart and lungs.

• Relaxation Techniques: Relaxation techniques such as breathing exercises, yoga, Tai chi, etc., can reduce the symptoms of shortness of breath.

• Medication: Inhalational drugs, such as bronchodilators, are prescribed for people with asthma and COPD. Medications are also given in the cases of anxiety disorders to help with shortness of breath.

• Oxygen Therapy: It is prescribed by the doctor if the oxygen level is severely reduced. Oxygen therapy is done by delivering oxygen through the mask.

What Are At Home Treatments for Shortness of Breath?

As shortness of breath is not considered an emergency, a person can try to reduce its severity at home.

• Pursed Lip Breathing: It is effective in cases where shortness of breath is caused due to COPD, panic attacks, or hyperventilation. In this technique, a person is advised to breathe through the nose on a count of two, followed by pursing the lips. After this, air is exhaled through pursed lips on a count of four.

• Sleeping in a Relaxed Position: Keeping pillows between the legs and head raised by pillows and keeping the back straight will help manage shortness of breath.

• Lifestyle Changes: Changing food habits, maintaining a healthy weight, quitting alcohol and tobacco, avoiding pollutant exposure, etc. can prevent shortness of breath to a certain extent.

Conclusion:

Shortness of breath is a condition that affects older people more than younger people. It occurs in older people for many reasons, including heart and lung problems. COPD, pulmonary embolism, atelectasis, anemia, heart attack, etc., are some causes of heart attack in older people. The treatment options for shortness of breath include exercise, medications, relaxation techniques, and oxygen therapy. With proper medical support and home remedies, shortness of breath is curable.