Table 2. Challenges in the clinical history of heart failure in older adults.

Atypical symptoms	Malaise, confusion, irritability, anorexia, sleep disturbance, decreased activity, abdominal complaints
Alternative explanations for symptoms	Fluid retention: drug (NSAIDS), venous insufficiencyDyspnea: COPD, anemia, pneumoniaFatigue: anemia, hypothyroidism, obesity, deconditioning, depression
Minimize symptoms	“I just can't get around, I'm 87”
Fewer exertional symptoms	Osteoarthritis, sarcopenia, loss of balance, poor vision

COPD: chronic obstructive pulmonary disease; NSAIDS: Non-steroidal anti-inflammatory drugs.