Dyspnoea in the elderly: a clinical approach to diagnosis.

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.