Quality of Life in Elderly Dyspnea Patients

  • A. Hooshiaran
  • F. van der Horst
  • G. Wesseling
  • J. J. M. H. Strik
  • J. A. Knottnerus
  • A. Gorgels
  • A. Fastenau
  • M. van den Akker
  • J. W. M. Muris
Reference work entry


 Dyspnea is a subjective term. Psychosocial or cultural parameters may influence the reaction of individuals to a certain sensation of breathing discomfort. The context in which dyspnea occurs can also impact its perception. Most of underlying diseases of dyspnea are progressive, frustrating and debilitating and their influence permeates every aspect of the patient’s life. In most elderly patients with chronic dyspnea, the specific cause of the dyspnea is usually elusive and because of coexistence of multiple causes a specific treatment is not available; so treatment should be aimed at symptom relief.

Research literature concerning dyspnea as a symptom in the elderly is scarce, although much has been written about specific diseases that may cause dyspnea, especially  chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). As the prevalence of these conditions increases with advancing age, dyspnea becomes an important cause of decrease in  quality of life and morbidity in the elderly. To get a better view of this impact we need standardized means to quantify dyspnea. There are several objective instruments available to measure dyspnea. Much of them focus on quantifying the functional consequences of dyspnea, such as decreased activity, which have the potential to dramatically impact quality of life and translate into impairment and disability.

In this chapter diagnostic procedures and measurement of dyspnea and its consequences are discussed. Furthermore, current evidence based effective methods to manage and rehabilitate elderly patient with dyspnea are summarized.


Chronic Obstructive Pulmonary Disease Congestive Heart Failure Chronic Obstructive Pulmonary Disease Patient Panic Disorder Pulmonary Rehabilitation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:


arterial blood gas


 activities of daily life


baseline dyspnea index


brain natriuretic peptide


coronary artery disease


 clinical COPD questionnaire


chronic heart failure


chronic heart failure questionnaire


chronic obstructive pulmonary disease


cardiac  rehabilitation program


chronic respiratory questionnaire/-dyspnea subscale


chest X ray




forced expiratory volume in 1 s


health related quality of life


kansas cardiomyopathy clinical questionnaire


modified borg scale


metabolic equivalent tasks


minnesota living with heart failure


medical research council


myocardial volume oxygen (consumption)


non-fearful panic disorder


New York heart association


occupation therapy


pulmonary functional status and dyspnea questionnaire/-modified


quality of life


short-form 36-item questionnaire


St. George’s respiratory questionnaire


quality of life questionnaire in severe heart failure


sickness impact profile


seattle obstructive lung disease questionnaire


transition dyspnea index


visual analogue scale


World Health Organization


  1. Albert US, Koller M, Lorenz W, Kopp I, Heitmann C, Stinner B, Rothmund M, Schulz KD. (2002). Breast. 11: 324–334.PubMedCrossRefGoogle Scholar
  2. American Thoracic Society. (1999). Am J Respir Crit Care Med. 159: 321–340.Google Scholar
  3. Anderson KL, Burckhardt CS. (1999). J Adv Nurs. 29: 298–306.PubMedCrossRefGoogle Scholar
  4. Apostolakis E, Akinosoglou K. (2007). Am J Cardiol. 100: 911–912.PubMedCrossRefGoogle Scholar
  5. Austin J, Williams R, Ross L, Moseley L, Hutchison S. (2005). Eur J Heart Fail. 7: 411–417.PubMedCrossRefGoogle Scholar
  6. Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JA, Franklin B, Sanderson B, Southard D. (2007). J Cardiopulm Rehabil Prev. 27: 121–129.PubMedGoogle Scholar
  7. Beitman BD, Basha I, Flaker G, DeRosear L, Mukerji V, Lamberti J. (1987). Behav Res Ther. 25: 487–492.PubMedCrossRefGoogle Scholar
  8. Bunout D, Barrera G, de la Maza P, Avendano M, Gattas V, Petermann M, Hirsch S. (2001). J Nutr. 131: 2441S–2446S.PubMedGoogle Scholar
  9. Carrasco Garrido P, de Miguel Diez J, Rejas Gutierrez J, Centeno AM, Gobartt Vazquez E, Gil de Miguel A, Garcia Carballo M, Jimenez Garcia R. (2006). Health Qual Life Outcomes. 4: 31.PubMedCrossRefGoogle Scholar
  10. Christenbery TL. (2005). Heart Lung. 34: 406–414.PubMedCrossRefGoogle Scholar
  11. Ciccone AM, Meyers BF, Guthrie TJ, Davis GE, Yusen RD, Lefrak SS, Patterson GA, Cooper JD. (2003). J Thorac Cardiovasc Surg. 125: 513–525.PubMedCrossRefGoogle Scholar
  12. Covey MK, Larson JL, Wirtz SE, Berry JK, Pogue NJ, Alex CG, Patel M. (2001). J Cardiopulm Rehabil. 21: 231–240.PubMedCrossRefGoogle Scholar
  13. Curkendall SM, DeLuise C, Jones JK, Lanes S, Stang MR, Goehring E Jr, She D. (2006). Ann Epidemiol. 16: 63–70.PubMedCrossRefGoogle Scholar
  14. Derom E, Marchand E, Troosters T. (2007). Ann Readapt Med Phys. 50: 615–626, 602–614.PubMedGoogle Scholar
  15. Dolansky MA, Moore SM, Visovsky C. (2006). J Gerontol Nurs. 32: 37–44.PubMedGoogle Scholar
  16. Fleet RP, Martel JP, Lavoie KL, Dupuis G, Beitman BD. (2000). Psychosomatics. 41: 311–320.PubMedCrossRefGoogle Scholar
  17. Guyatt GH, Feeny DH, Patrick DL. (1993). Ann Intern Med. 118: 622–629.PubMedGoogle Scholar
  18. Hanania NA, Darken P, Horstman D, Reisner C, Lee B, Davis S, Shah T. (2003). Chest. 124: 834–843.PubMedCrossRefGoogle Scholar
  19. Havranek EP, Masoudi FA, Westfall KA, Wolfe P, Ordin DL, Krumholz HM. (2002). Am Heart J. 143: 412–417.PubMedCrossRefGoogle Scholar
  20. Huijnen B, Horst F, van der van Amelsvoort L, Wesseling G, Lansbergen M, Aarts P, Nicolson N, Knottnerus JA. (2006). Fam Pract. 23: 34–39.PubMedCrossRefGoogle Scholar
  21. Jaarsma T, Halfens R, Abu-Saad HH, Dracup K, Stappers J, van Ree J. (1999). Eur J Heart Fail. 1: 151–160.PubMedCrossRefGoogle Scholar
  22. Jolliffe JA, Rees K, Taylor RS, Thompson D, Oldridge N, Ebrahim S. (2004). Cochrane Database Syst Rev. CD001800.Google Scholar
  23. Kayahan B, Karapolat H, Atyntoprak E, Atasever A,Ozturk O. (2006). Respir Med. 100: 1050–1057.PubMedCrossRefGoogle Scholar
  24. Kroenke K, Mangelsdorff AD. (1989). Am J Med. 86: 262–266.PubMedCrossRefGoogle Scholar
  25. Kubo SH, Schulman S, Starling RC, Jessup M, Wentworth D, Burkhoff D. (2004). J Card Fail. 10: 228–235.PubMedCrossRefGoogle Scholar
  26. Kuijpers PM, Honig A, Griez EJ, Braat SH, Wellens HJ. (2000). Ned Tijdschr Geneeskd. 144: 745–749.PubMedGoogle Scholar
  27. Lareau SC, Meek PM, Roos PJ. (1998). Heart Lung. 27: 159–168.PubMedCrossRefGoogle Scholar
  28. Lesman-Leegte I, Jaarsma T, Sanderman R, Hillege HL, van Veldhuisen DJ. (2008). Eur J Cardiovasc Nurs. 7: 121–126.PubMedCrossRefGoogle Scholar
  29. Lorenzi CM, Cilione C, Rizzardi R, Furino V, Bellantone T, Lugli D, Clini E. (2004). Respiration. 71: 246–251.PubMedCrossRefGoogle Scholar
  30. Mahler DA, Fierro-Carrion G, Baird JC. (2003). Clin Geriatr Med. 19: 19–33, v.PubMedCrossRefGoogle Scholar
  31. Mahler DA, Weinberg DH, Wells CK, Feinstein AR. (1984). Chest. 85: 751–758.PubMedCrossRefGoogle Scholar
  32. Meek PM. (2004). Chron Respir Dis. 1: 29–37.PubMedGoogle Scholar
  33. Morgan WC, Hodge HL. (1998). Am Fam Physician. 57: 711–716.PubMedGoogle Scholar
  34. Nonoyama ML, Brooks D, Lacasse Y, Guyatt GH, Goldstein RS. (2007). Cochrane Database Syst Rev. CD005372.Google Scholar
  35. O’Connor GT, Buring JE, Yusuf S, Goldhaber SZ, Olmstead EM, Paffenbarger RS Jr, Hennekens CH. (1989). Circulation. 80: 234–244.PubMedGoogle Scholar
  36. Peruzza S, Sergi G, Vianello A, Pisent C, Tiozzo F, Manzan A, Coin A, Inelmen EM, Enzi G. (2003). Respir Med. 97: 612–617.PubMedCrossRefGoogle Scholar
  37. Puente-Maestu L, Sanz ML, Sanz P, Ruiz de Ona JM, Rodriguez-Hermosa JL, Whipp BJ. (2000). Eur Respir J. 15: 1026–1032.PubMedCrossRefGoogle Scholar
  38. Rector TS. (2005). J Card Fail. 11: 173–176.PubMedCrossRefGoogle Scholar
  39. Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, Make B, Rochester CL, Zuwallack R, Herrerias C. (2007). Chest. 131: 4S–42S.PubMedCrossRefGoogle Scholar
  40. Rutten FH, Cramer MJ, Lammers JW, Grobbee DE, Hoes AW. (2006). Eur J Heart Fail. 8: 706–711.PubMedCrossRefGoogle Scholar
  41. Schrier AC, Dekker FW, Kaptein AA, Dijkman JH. (1990). Chest. 98: 894–899.PubMedCrossRefGoogle Scholar
  42. Spector WD, Katz S, Murphy JB, Fulton JP. (1987). J Chronic Dis. 40: 481–489.PubMedCrossRefGoogle Scholar
  43. Spilker, B, Revicki, DA. (1999). In: Taxonomy of Quality of Life. Quality of Life and Pharmacoeconomics in Clinical Trials. Lippincott-Raven, Philadelphia, pp. 25–32.Google Scholar
  44. Strik JJ, van Praag HM, Honig A. (2003). Tijdschr Gerontol Geriatr. 34: 104–112.PubMedGoogle Scholar
  45. Tessier JF, Nejjari C, Letenneur L, Filleul L, Marty ML, Barberger Gateau P, Dartigues JF. (2001). Eur J Epidemiol. 17: 223–229.PubMedCrossRefGoogle Scholar
  46. Thoonen BPA, van Weel C. (2002). Huisarts Wet. 45: 414–419.CrossRefGoogle Scholar
  47. Vallet G, Ahmaidi S, Serres I, Fabre C, Bourgouin D, Desplan J, Varray A, Prefaut C. (1997). Eur Respir J. 10: 114–122.PubMedCrossRefGoogle Scholar
  48. Molen T, van der Willemse BW, Schokker S, ten Hacken NH, Postma DS, Juniper EF. (2003). Health Qual Life Outcomes. 1: 13.PubMedCrossRefGoogle Scholar
  49. Zuwallack R. (2007). Proc Am Thorac Soc. 4: 549–553.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • A. Hooshiaran
  • F. van der Horst
  • G. Wesseling
  • J. J. M. H. Strik
  • J. A. Knottnerus
  • A. Gorgels
  • A. Fastenau
  • M. van den Akker
  • J. W. M. Muris

There are no affiliations available

Personalised recommendations