Synopsis There are normal changes to sleep architecture throughout the lifespan. There is not, however, a decreased need for sleep and sleep disturbance is not an inherent part of the aging process. Sleep disturbance is common in older adults because aging is associated with an increasing prevalence of multimorbidity, polypharmacy, psychosocial factors affecting sleep, and certain primary sleep disorders. It is also associated with morbidity and mortality. Since many older adults will have several factors from different domains affecting their sleep, these complaints are best approached as a multifactorial geriatric health condition, necessitating a multifaceted treatment approach.

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Objectives The evaluation of dyspnea in older persons is traditionally focused on cardiorespiratory diseases, rather than systematically evaluating the multiple impairments that often occur with advancing age and which may also contribute to dyspnea. Accordingly, we have evaluated the associations between a broad array of cardiorespiratory and non-cardiorespiratory impairments and dyspnea in older persons. Design Cross-sectional. Setting Cardiovascular Health Study. Participants 4,413 community-dwelling persons; mean age was 72.6, 57.1% were female, 4.5% were African-American, 27.2% had less than a high school education, and 54.7% were ever-smokers. Measurements Dyspnea severity (American Thoracic Society grade ≥2 defined moderate-to-severe) and several impairments, including those established by: spirometry (forced expiratory volume in 1-second [FEV1]), maximal inspiratory pressure (respiratory muscle strength), echocardiography, ankle-brachial index, blood pressure, whole-body muscle mass (bioelectrical impedance), single chair stand (lower extremity function), grip strength, serum hemoglobin and creatinine, Center for Epidemiologic Studies Depression Scale (CES-D), Mini Mental State Examination, medication use, and body mass index (BMI). Results In a multivariable logistic regression model, impairments having strong associations with moderate-to-severe dyspnea included: FEV1