Q.My wife has complained of being short of breath while shopping in the mall. She says its just a sign of age, but Im concerned about her.

A. The likelihood of suffering shortness of breath or dyspnea (disp-nee-ah) becomes greater the older we get. As we age, our air passages get smaller, chest muscles weaken, and our lungs become less flexible. These changes reduce our air flow.

Dyspnea should happen rarely to healthy people. It can be brought on by exhaustive exertion, high altitude, extreme temperatures. Otherwise, shortness of breath is commonly a sign of a medical problem. So your wife should get this symptom checked by a doctor immediately.

Dyspnea is associated with the major breathing disorders that can develop in seniors. These disorders are chronic obstructive pulmonary disease (COPD), asthma, obstructive sleep apnea, pulmonary fibrosis, pulmonary thromboembolism and aspiration.

COPD involves difficulty in exhaling. Emphysema and chronic bronchitis are COPDs. Emphysema makes the small air spaces in the lungs collapse. Bronchitis is inflammation of the airways.

Most asthma is caused by allergies to airborne particles such as dust and mold. The airways become inflamed, which causes them to spasm. Unlike COPD, asthma is reversible.

Diagnosing conditions in seniors can be challenging, because asthma in older people is often difficult to distinguish from emphysema and chronic bronchitis. In addition, many seniors have both emphysema and chronic bronchitis.

Obstructive sleep apnea is common in older adults. People with sleep apnea stop breathing for as long as 30 seconds at a time. These interruptions can happen hundreds of times a night. Obstructive sleep apnea occurs when the muscles in the back of your throat relax, narrowing your airway and cutting off your breathing.

In pulmonary fibrosis, the lungs air sacs become filled with scar tissue. The damage is permanent. Pulmonary fibrosis usually begins in your 40s or 50s, but can develop at any age.

Pulmonary thromboembolism is a life-endangering blockage of a blood vessel by a blood clot that travels often from the legs to the lung and damages tissue. Pulmonary thromboembolism is most common after age 65.

When something from your mouth goes down the wrong pipe, you have aspiration. Aspiration is inhaling food particles, liquids or bacteria. If the amount of aspirated material exceeds the ability of the immune system to handle it, you can get a serious lung infection.

Symptoms of shortness of breath can be caused by a variety of abnormalities in organs other than the lungs.

When the heart fails, it loses its ability pump blood. This elevates pressure in the blood vessels around the lung. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

A low red-blood-cell count causes dyspnea because the red cells carry oxygen. When their number is extremely low, your body doesnt get enough oxygen.

In addition, a high thyroid level, shock, systemic infection, kidney or chronic liver problems, stroke, nerve and muscle disorders, and anxiety can bring on dyspnea.

The following are some symptoms that indicate a medical condition: shortness of breath at rest, with exercise, when lying down or upon exposure to allergens. In addition, you may have a problem if shortness of breath is accompanied by: chest pain or discomfort, arm pain, jaw pain, neck pain, swelling in the ankles and feet, fluid weight gain or unintentional weight loss with reduced appetite, unusual fatigue, sweating, yellow or green phlegm, blood in spit, fever, wheezing, persistent cough, blue lips or fingertips, fainting.

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