Breathing Problems and Alzheimer’s Disease

WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Logo for UNC Chapel Hill, Cecil G. Sheps Center

When your loved one with Alzheimer's disease has breathing problems, they feel like they have to work harder than usual to get air. They might also feel like they can’t take a deep breath or get enough air. The problem can start suddenly or come on slowly over weeks or months.

Call 911 right away if:

  • They’ve inhaled an object or a piece of food.
  • They suddenly have breathing problems along with chest pain, a queasy feeling, sweating a lot, or are throwing up.
  • They have sudden breathing trouble as well as a rash, itching, or swelling. This could be a serious allergic reaction.
  • They suddenly have trouble breathing and also have leg pain and swelling and sharp chest pain.
  • Their skin, lips, or fingernails turn purple or blue.
  • They can’t say more than a few words without needing to take a breath.
  • They can’t lie down because they can’t breathe.
  • They’re straining their neck muscles trying to breathe.

Call their doctor if:

  • They have breathing problems that are new or get worse when they do things like climb stairs.
  • They have trouble breathing when they’re anxious, angry, or in pain.
  • They also have a fever.

Causes

Breathing problems aren’t normal for anyone, but they’re common in older people, including those with Alzheimer’s disease. They can be caused by many conditions, such as:

  • Asthma. This can make your airways (the tubes that carry air into the lungs) narrow. People who have it often wheeze.
  • Anxiety. Emotions like fear and anger can affect breathing and make any existing breathing problems worse.
  • Respiratory infection. Airway or lung infections (such as bronchitis or pneumonia) cause coughing, fever, and mucus.
  • Choking. Foods like peanuts or partly chewed meat can block airways.
  • Diet and exercise. People who are overweight or who don’t exercise regularly might have trouble catching their breath when they do something active.
  • Blood clot in the lungs (pulmonary embolism). This can cause sudden problems with breathing alone, or breathing problems with coughing, sharp chest pain, leg pain, and leg swelling.
  • Chronic obstructive pulmonary disease (COPD). This is a long-term lung problem that’s most common among people who smoke. It’s sometimes called emphysema or chronic bronchitis.
  • Collapsed lung (pneumothorax). This can cause sudden trouble breathing with sharp, stabbing chest pain.
  • Heart attack. This can cause trouble breathing along with a feeling of pain or pressure on the chest.
  • Heart failure. This is when the heart loses some of its power to pump blood. Other signs include coughing along with swelling in the lower legs and belly that’s new or gets worse.
  • Serious allergic reaction (anaphylaxis). This can also cause a rash, itching, and swelling.

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Breathing Exercises

Controlled breathing is a way of breathing that helps get as much air into the lungs as possible. To help your loved one do this:

  • Have them sit up straight. This makes it easier for air to move into and out of the lungs.
  • Have them breathe in through their nose. Then have them purse their lips and breathe out slowly, as if they were whistling. Tell them to breathe out until they feel like all the air in their lungs is gone. Try to have them breathe out for twice as long as they breathe in. This helps them fully empty their lungs before breathing in more air.
  • Ask them to put one hand on their chest and one hand on their stomach. When they breathe in, the hand on the stomach should rise higher than the hand on the chest. This makes sure that the big muscle under the lungs (diaphragm) is helping the lungs to open fully. If possible, have your loved one practice this several times a day, when they are relaxed and breathing normally. This way, they’ll know how to do it when they do have trouble breathing.

Remember that not everyone can do controlled breathing, especially people who have a hard time understanding and following directions.

Manage Breathing Problems

Asthma . If your loved one has asthma, help them avoid things like cigarette smoke, perfumes, dust, animal dander, mold, and pollen. Make sure they take their medicine or use an inhaler if their doctor has prescribed it for them.

Anger and anxiety. These emotions can cause breathing problems, but breathing problems can also cause these emotions. Depending on the situation, you can try some different things to help your loved one be more comfortable.

If you think that anger or anxiety is making it hard for them to breathe:

  • Comfort them by talking to them calmly. If they’ll let you, hold their hand or put a hand on their shoulder.
  • Distract them by having them do something they like to do, offer them something they like to eat, or play music they like.
  • If they get more anxious or angry, give them space and try again in a few minutes.
  • If you think the breathing problems are causing the anger and anxiety:
  • Talk to them calmly. Try a gentle touch if they’ll let you.
  • Help them change their body position to make breathing easier.
  • Use a fan to blow cool air over their face if this doesn’t upset them.
  • Have them try breathing exercises.
  • If they don’t understand your instructions, don’t try to explain. Try to distract them.
  • If their breathing problems get worse or they seem to be sick, call for help.

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Breathing Problems in Daily Life

Sometimes doing things like bathing, using the bathroom, or getting dressed can make breathing problems worse.

If your loved one is having trouble with daily activities, you can do some things to help them:

  • Break activities into smaller tasks and let them take rest breaks in between.
  • Use simple one- or two-step directions so they don’t feel overwhelmed.
  • Try using aids to support them, such as using a walker or a bath stool or bench during bathing.
  • Give them lots of chances to use the bathroom so they don’t have to rush or feel anxious.
  • Put chairs around the house so they can stop and catch their breath if they need to.

Prevent Breathing Problems

You can do some things to help keep your loved one from having breathing trouble.

  • Stay away from things like big and sudden changes in temperature, air pollution, pollen, cigarette smoke, chemical fragrances, and dust.
  • Have your loved one eat five or six smaller meals every day instead of three large ones. Remind them to eat slowly. Help them to cut out or cut down on foods that may cause gas, like onions, cabbage, Brussels sprouts, beans, bubbly drinks like sodas, and spicy foods.
  • Have them drink lots of water and eat a diet high in fiber. This will keep them from getting constipated and straining on the toilet. Help them stay away from high-energy activity for 1 hour after eating.
  • Exercise can help ease some breathing problems. Before starting, ask their doctor what kinds of exercise are right for your loved one.
  • Ask their doctor about flu and pneumonia shots.
WebMD Medical Reference in Collaboration with the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill Reviewed by Melinda Ratini, DO, MS on August 26, 2018

Sources

SOURCES:

UpToDate: “Approach to the patient with dyspnea,” “Evaluation of the adult with dyspnea in the emergency department,” “Patient information: Shortness of breath (dyspnea) (Beyond the Basics).”

American Journal of Respiratory Critical Care Medicine: “Dyspnea. Mechanisms, Assessment, and Management: A Consensus Statement.”

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