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An older person experiencing a heart attack or suffering from pneumonia or other ailments may have unusual symptoms that can mask the disease and stymie doctors or relatives who are trying to figure out what is wrong.

This finding is among research results reported in the August issue of Prevention Magazine.Most diagnostic difficulties occur in older people with several medical problems, but even robust elderly people can have surprising symptoms, according to Dr. Ken Schmader of Duke University Medical School.

For example, an older person with a heart attack, especially someone over 80, may experience only minor chest pain. In this age group, wooziness, fainting, confusion and/or shortness of breath are often the best tips that a heart attack is under way.

Similarly, "one sign of a heart attack can be a fall," said Deborah Friedlander, assistant professor of geriatrics at New York Hospital-Cornell Medical Center.

She said the process of diagnosis is very tricky with older people because they suffer many more "silent" cardiac events, the kind that don't show up on a electrocardiogram, than do younger people.

Other diseases that may show offbeat symptoms in older people include:

- Pneumonia: Older people often have no chills, fever, cough or chest pain. Instead, confusion may be the only symptom, says Dr. Bruce Leff of Johns Hopkins Medical School. Look for cognitive changes or fatigue, Leff said.

- Diabetes: This is a seriously sneaky disease in the aged. Often, elders do not have either an unquenchable thirst or an urge to urinate frequently, both hallmarks of diabetes among younger people. Checking the blood sugar is the only accurate test of diabetes for those 65 and older.

- Hyperthyroidism: The classic symptoms include a racing heart, trouble sleeping, weight loss and high energy. In older people, the signs may be confusion, anxiety, depression and low energy.