COPD: Dizziness, Fatigue and Falls

June 4th, 2014

Lung disease can affect much more than just your breathing. In fact, COPD and other chronic respiratory issues can cause shortness of breath. This leaves you feeling dizzy, weak, and fatigued. Not being able to breathe well depletes the oxygen levels in your blood, affecting your body’s ability to function properly.

If you have COPD or a similar lung disease, you are at an increased risk of losing your balance, falling, or even blacking out. In fact, a study published in the medical journal Respiratory Medicine shows that about a third of patients with COPD suffered at least one fall during the six months of the study. For this reason, it’s especially important for seniors with breathing issues to be prepared in case of a fall.

What is COPD?

COPD stands for chronic obstructive pulmonary disease: a group of long-term lung diseases. These include chronic bronchitis (inflammation of the airways) and emphysema (damage affecting the air sacs at the end of the lung’s airways). These conditions makes breathing difficult.

It’s estimated that around 30 million Americans are affected by COPD 1. In fact, it is the third biggest cause of disease-related death in the country. Many people are unaware that they even have the condition.

If left untreated though, COPD can lead to respiratory infections and heart issues. Thankfully, the condition can be prevented or alleviated by stopping smoking and reducing your exposure to air pollution and irritants, such as chemicals and dust.

What causes COPD?

Smoking is the main cause of COPD, with as much as 90% of all COPD cases being linked to tobacco. The longer you smoke, the higher your risk of developing COPD. You’re also more likely to get COPD if you have asthma and smoke. However, nonsmokers can also be diagnosed with the condition. Pollution and secondhand smoke in the environment can also cause COPD, as can exposure to dust, fumes, and chemicals.

Some people may also be genetically predisposed to a rare form of COPD called Alpha-1 deficiency-related emphysema. Around 5% of people with COPD are deficient in a protein known as alpha-1-antitrypsin 2. This deficiency can lead to other problems which can affect the lungs and liver.

COPD Symptoms

Many people don’t recognize the early symptoms of COPD. These include a mild but recurrent cough, shortness of breath and the feeling of needing to frequently clear your throat. This can often be mistaken as a cough, cold or just general signs of aging. However, these symptoms can progress to include:

  • Shortness of breath during day-to-day activities, such as walking up stairs
  • Chronic coughing
  • Wheezing
  • Tightness of the chest
  • Regular production of mucus
  • Frequent respiratory infections
  • Fatigue and lack of energy
  • Weight loss
  • Blueness of fingernail beds or lips
  • Swelling in legs, ankles, or feet

If you have any of these symptoms or suspect you may have COPD, you should see your doctor. The earlier you are diagnosed with COPD, the more successful your treatment will be.

COPD Diagnosis and Treatment

COPD symptoms can quickly become disabling, although most of them can be greatly reduced through treatment. Before treatment begins, however, a diagnosis must be made.

Differentiating between COPD and another respiratory issue requires a series of tests. These are to determine the health, function, and capacity of the lungs. When diagnosing COPD, Cleveland Clinic uses chest X-rays, blood gas testing, pulse oximetry monitoring, lung compliance and volume tests, cardiopulmonary stress tests, spirometry, and methacholine challenge tests.

According to the American Lung Association, each case of COPD is different, and no one treatment is right for everyone. The doctor will create a treatment plan based on symptoms, needs, and abilities. Fortunately, a variety of medications work well to combat COPD. These include corticosteroids, bronchodilators, and anti-cholinergic. If daily activities are greatly impaired due to reduced lung function, supplemental oxygen can be prescribed.

How Does COPD Impact Your Risk of Falling?

COPD and other lung diseases raise your fall risk more than most other conditions. Our analysis of 145,000 Lifeline users shows that individuals with COPD fell 40 percent more than those without a chronic condition. When studying a large group of senior women, a 2003 study published in BMJ also found that COPD played a role in more falls than other chronic conditions such as circulatory disease and coronary heart disease.

There are several ways COPD increases your fall risk. Primarily, COPD prevents your blood from being properly oxygenated. This means your organs and brain are not receiving the oxygen they need. This leads to chronic dizziness and can result in blackouts. Other symptoms of lung disease that increase your risk of falling include weakness in your leg muscles and impaired balance. Balance and strength are critical to staying steady on your feet.

There may also be other symptoms from COPD that affect your fall risk. Chronic breathing issues can cause malnutrition and other nutritional deficits, depression, and cognitive impairments, among other problems. More studies are needed to understand the role these risk factors may play, according to an article published in Respiratory Medicine.

COPD, Breathing Difficulties and Falling

Joyce Johnson is a respiratory therapist and Director of Outreach and Cessation Programs at the Breathing Association in Columbus, Ohio. The educational/outreach organization began 110 years ago in response to the tuberculosis epidemic sweeping the country at the time. The association now offers a number of programs to people with COPD across the Columbus area.

Johnson says that there is one simple, often neglected reason that people with COPD fall. “They often sit longer than people without breathing problems, making it harder for them to get up and more out-of-breath when they do. Then panic takes over quickly, further increasing the likelihood of a fall. Panic and anxiety go hand-in-hand with COPD. And people with COPD often also have heart disease, making it that much harder for them to breathe.”

She also notes that COPD patients often have a lot of respiratory equipment. This can be a challenge to maneuver around. They can have up to 50 feet of hose in the house, making it all-too-easy to trip, she says.

Paul Adams, Senior Director of Product Management for Lifeline, also notes that the medications people take for COPD and asthma can significantly increase the risk of falling. “For example, medications for asthma often tend to be stimulants. They can make people move more quickly and lose their balance. And of course, just finding it difficult to breathe can case someone to panic, also increasing the risk of a fall.”

Seven Stress Management Tips for People with COPD

If you have COPD, there are several easy steps you can take to alleviate its impact on your day-to-day life.

1. Exercise:

It’s no secret that regular exercise benefits not just your body but also your mood. You may be reluctant to exercise for fear of triggering an attack, but gentle exercises can help. Speak with your doctor about an exercise regime that can be right for you. If advised, sign up for a restorative yoga class or take slow walks outside. Bring a friend with you if possible and carry a cell phone or wear a GPS-enabled medical alert necklace in case you need assistance.

2. Relaxation:

Basic relaxation techniques can significantly reduce stress. Audiobooks offer guided meditations and relaxation regimens that can help you “chill out.” You can also teach your muscles to relax by tensing and then releasing each muscle group, starting with your feet and moving up through the rest of your body.

3. Breathing Exercises:

Specialized breathing exercises have been devised specifically to help people with impaired breathing. Check your local library or the Internet for more information.

4. Improve Your Diet:

Cut back on empty calories like cake, cookies, and candy. Replace them with fresh fruits and vegetables and foods rich in fiber, vitamin D, and calcium.

5. Say No to Alcohol and Soda:

Beer and hard liquor are high in sugar, and carbonated beverages may also cause bloating. Stay healthier with natural drinks like spring water.

6. Seek Counseling:

If you find yourself feeling overwhelmed and emotionally burdened, seek out a counseling service. Working on the mind part of the “mind-body connection” is a way to feel better.

7. Strengthen Community Ties:

Stay in touch with your family. Contact old friends and look for new ones. Join a community group that interests you. If you have a computer, reach out through e-mail or social media like Facebook. If you don’t have a computer, you can always find one at your local library.

How to Prepare for a Fall

While it’s worthwhile to discuss ways to minimize your fall risk with your doctor, it’s also a good idea to be prepared in case you do fall. One of the best ways to ensure you can get help as soon as possible after a fall is to invest in a medical alert system. These devices contact a call center with just the push of a button.

A trained response center operator will promptly respond. They can help you determine if you need emergency medical attention or assistance from a friend or family member. You’ll feel more confident knowing help can be accessed quickly, enabling you to remain independent longer.

A device with built-in fall detection may be a good idea for seniors with lung disease, because you may not be able to call for help if a blackout occurs. Modern fall detection systems are highly accurate and can detect most types of falls. The HomeSafe with AutoAlert system, for example, detects greater than 95 percent of many types of falls.1

COPD not only makes it difficult to breathe, but it can also affect your mobility and drastically increase your fall risk. Being prepared for a fall is the best way to stay safe and healthy. Investing in a medical alert system is also investing in your sustained health and independence.

Resources on COPD

Resources exist for seniors and their caretakers to learn more and share their experiences. The American Lung Association runs an online support group for those with COPD, their caregivers, and their loved ones. Better Breathers Clubs offer both practical knowledge and emotional support.

It pays to keep a close eye on your health and to see a doctor any time you have concerns. COPD and other chronic diseases that affect the lungs and heart can have a huge impact on senior health, quality of life, and even independence.


Don’t disregard professional medical advice, or delay seeking it, because of what you read here.

This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter and seek professional attention immediately if you think you or someone in your care may be experiencing a healthcare condition or medical emergency.