title: Geriatric dyspnea: doing worse, feeling better.
abstract: Older age is associated with a decline in physical fitness and reduced efficiency of the respiratory system. Paradoxically, it is also related to reduced report of dyspnea, that is, the experience of difficult and uncomfortable breathing. Reduced symptom reporting contributes to misdiagnosis or late diagnosis of underlying disease, suboptimal treatment, faster disease progression, shorter life expectancy, lower quality of life for patients, and considerably increased costs for the health care system in an aging society. However, pathways in the complex relationship between dyspnea and age are not well explored yet. We propose a model on geriatric dyspnea that integrates physiological, neurological, psychological and social pathways which link older age with dyspnea perception and expression. We suggest that the seemingly paradox of reduction of dyspnea in older age, despite physiological decline, can be solved by taking age-related changes on these multiple levels into account. In identifying these variables, the Geriatric Dyspnea Model highlights risk factors for reduced dyspnea perception and report in older age and pathways for intervention.
authors.affiliation: KU Leuven, Research Group on Health Psychology, Tiensestraat 102, 3000 Leuven, Belgium. Electronic address: sibylle.petersen@psy.kuleuven.be.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Petersen
authors.affiliation: KU Leuven, Research Group on Health Psychology, Tiensestraat 102, 3000 Leuven, Belgium.
authors.forename: Andreas
authors.initials: A
authors.lastname: von Leupoldt
authors.affiliation: KU Leuven, Research Group on Health Psychology, Tiensestraat 102, 3000 Leuven, Belgium.
authors.forename: Omer
authors.initials: O
authors.lastname: Van den Bergh
mesh_terms: D000368:Aged; D000375:Aging / Q000473:pathology*; D004417:Dyspnea / Q000503:physiopathology* / Q000523:psychology; D004644:Emotions; D006801:Humans; D008954:Models, Biological; D011788:Quality of Life
keywords: Age; Aging; Breathlessness; Dyspnea; Emotion regulation; Interoception