KU Leuven, Research Group on Health Psychology, Tiensestraat 102, 3000 Leuven, Belgium.
KU Leuven, Research Group on Health Psychology, Tiensestraat 102, 3000 Leuven, Belgium.
Ageing Res Rev. 2014 May;15:94-9. doi: 10.1016/j.arr.2014.03.001. Epub 2014 Mar 24.
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.
年龄增长与身体机能下降和呼吸系统效率降低有关。但具有矛盾性的是，年龄增长也与呼吸困难报告减少有关，即呼吸困难的体验减少。症状报告减少会导致潜在疾病的误诊或延迟诊断、治疗效果不佳、疾病进展更快、预期寿命缩短、患者生活质量下降，以及老龄化社会中医疗保健系统的成本大幅增加。然而，呼吸困难与年龄之间复杂关系的途径尚未得到充分探索。我们提出了一个关于老年呼吸困难的模型，该模型整合了生理、神经、心理和社会途径，将老年与呼吸困难的感知和表达联系起来。我们认为，尽管存在生理衰退，但老年人呼吸困难减少的这种看似矛盾的现象，可以通过考虑这些多个层面的与年龄相关的变化来解决。在确定这些变量时，老年呼吸困难模型突出了导致老年人呼吸困难感知和报告减少的危险因素，以及干预途径。
