La dyspnée du sujet très âgé

Only few data are available in the medical literature on dyspnea in older subjects. This symptom seems more frequent, but its perception and its way of expression are different. Dyspnea is a subjective sensation that results from a disequilibrium between needs and capacities of the respiratory system. As people get older, physiological changes lessen these capacities. The way of breathing changes: the tidal volume decreases, the frequency increases. Therefore, at exercise, dyspnea occurs earlier. Current measuring tools for dyspnea are poorly related to daily activities of the very elderly. New scales are being developed. However, changes in the perception of respiratory limitations change with ageing, such that dyspnea may not be reported in some pathologic situation. The causes of acute and chronic dyspnea in the elderly are multiple. There are some specifics: the frequency of venous thromboembolic disease, aspiration, and finally the often multifactorial nature of dyspnea. Markers such as BNP are interesting.