Journal article
Symptom Burden Among Community‐Dwelling Older Adults in the United States
Journal of the American Geriatrics Society (JAGS), Vol.67(2), pp.223-231
02/2019
DOI: 10.1111/jgs.15673
PMCID: PMC6367017
PMID: 30548453
Abstract
Objectives
To determine the prevalence and impact of common co‐occurring symptoms among community‐dwelling older adults in the United States.
Design
The National Health and Aging Trends Study is a nationally representative, prospective study with annual data collection between 2011 and 2017.
Setting
Community‐based, in‐person interviews (survey response rates, 71%–96%).
Participants
A total of 7,609 community‐dwelling Medicare beneficiaries, 65 years or older.
Measurements
Symptoms assessed at baseline include pain, fatigue, breathing difficulty, sleeping difficulty, depressed mood, and anxiety. Total symptom count ranged from zero to six. Several outcomes were examined, including grip strength, gait speed, and overall lower‐extremity function as well as incidence of recurrent falls (two or more per year), hospitalization, disability, nursing home admission, and mortality.
Results
Prevalence of zero, one, two, three, and four or more symptoms was 25.0%, 26.6%, 20.7%, 14.0%, and 13.6%, respectively. Symptom count increased with advancing age and was higher in women than in men. Pain and fatigue were the most common co‐occurring symptoms. Higher symptom count was associated with decreased physical capacity. For example, participants with one, two, three, and four or more symptoms had gait speeds that were 0.04, 0.06, 0.09, and 0.13 m/s slower, respectively, than those with no symptoms, adjusting for specific diseases, total number of diseases, and other potential confounders (P < .001). The risk of several adverse outcomes also increased with greater symptom count. For example, compared with those with no symptoms, the adjusted risk ratios for recurrent falls were 1.48 (95% confidence interval [CI] = 1.30–1.70), 1.54 (95% CI = 1.32–1.80), 1.90 (95% CI = 1.55–2.32), and 2.38 (95% CI = 2.00–2.83) for older adults with one, two, three, and four or more symptoms, respectively.
Conclusions
Symptoms frequently co‐occur among community‐dwelling older adults and are strongly associated with increased risk of a range of adverse outcomes. Symptoms represent a potential treatment target for improving outcomes and should be systematically captured in health records. J Am Geriatr Soc 67:223–231, 2019.
See related Editorial by Hunt et al. in this issue.
Details
- Title: Subtitle
- Symptom Burden Among Community‐Dwelling Older Adults in the United States
- Creators
- Kushang V. Patel - University of WashingtonJack M. Guralnik - University of Maryland, BaltimoreElizabeth A. Phelan - University of WashingtonNancy M. Gell - University of VermontRobert B. Wallace - University of IowaMark D. Sullivan - University of WashingtonDennis C. Turk - University of Washington
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.67(2), pp.223-231
- DOI
- 10.1111/jgs.15673
- PMID
- 30548453
- PMCID
- PMC6367017
- NLM abbreviation
- J Am Geriatr Soc
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Publisher
- John Wiley & Sons, Inc
- Number of pages
- 9
- Grant note
- National Institute on Aging (U01AG032947)
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984364450002771
Metrics
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