Overdiagnosis of COPD and asthma among elderly with chronic dyspnea

Abstract

<b>Introduction:</b> One third of people over 65, having frequent overdiagnoses of COPD/asthma, complain of dyspnea. <b>Aims and objectives:</b> We investigated geriatric population, whether unrelieved dyspnea was due to inaccurate diagnoses. <b>Methods:</b> Subjects over 65 years of age with chronic dyspnea were evaluated. Sociodemographic data, previous diagnoses and treatment were recorded. After physical examination, subjects underwent routine tests and performed spirometric tests. Differential diagnosis of dyspnea was made. <b>Results:</b> 200 subjects (57F:43M) finishing all diagnostic steps were recruited into study. 70% of them had a diagnosis of chronic obstructive lung disease (COPD), and 30% asthma. After diagnostic re-evaluation, the previous diagnoses of COPD and asthma were confirmed in 36.4% and 28.3% of the subjects, respectively (p&lt;0.001). Congestive heart failure (%17), bronchiectasis (%9.5), interstitial lung diseases (%9), obstructive sleep apnea (%4.5), scoliosis (%3.5), valvular heart diseases (%2.5), pulmonary arterial hypertension (%2), coronary heart disease (%2) are other diagnoses. On multiple regression analysis, male gender, cigarettes pack-year, FEV1/FVC, presence of emphysema and absence of pulmonary edema on chest X-ray significantly predicted COPD (p&lt;0.001, R2= 0.803). <b>Conclusions:</b> Geriatric population are overdiagnosed with COPD and/or asthma. Performing diagnostic procedures are essential evaluating the dyspnea in elderly. COPD, asthma, heart failure, valvular heart diseases, bronchiectasis, interstitial lung diseases and obstructive sleep apnea are frequent among elderly having chronic dyspnea.