Saturday, September 26, 2020
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How to Manage Multiple Symptoms in Older Patients

Older patients are more likely to report multiple symptoms that can negatively impact their quality of life and longevity, according to a new study. More than one symptom at a time can make each symptom feel worse. 

But how common are co-occurring symptoms among older adults and how do they impact wellbeing? Researchers from the National Health and Aging Trends Study examined survey answers from more than 7,500 community-dwelling participants 65 and older from 2010 to 2017 to find out. 

What Did The Study Find?

In the study, participants were asked questions about six physical and psychological symptoms: pain, fatigue, breathing difficulty, sleep difficulty, anxiety and depression, such as: “In the last month, have you been bothered by pain?” and “In the last month, did you have low energy or were you easily exhausted?” 

Researchers also examined demographic and health characteristics. Participants were asked about their chronic medical conditions, exercise routine, whether they had had an overnight hospital stay in the last year or any trouble performing daily functions, such as eating, using the bathroom, bathing, getting out of bed and getting dressed. Researchers measured and recorded participants’ grip strength, walking speed, balance and ability to rise from a chair too. 

After tallying the results, researchers determined the following:

  • Symptoms are common among older adults. In fact, 75 percent of the participants reported at one of the six symptoms. Nearly half of the participants had two or more symptoms and roughly 14 percent had four more symptoms. 
  • Some patients are more likely to report more symptoms that others. Women were more likely to report symptoms than men, Black and Hispanic individuals had more symptoms than whites, and older adults with lower levels of education had more symptoms than those with higher education levels. 
  • Lifestyle matters. Smoking, obesity, inactivity, cognitive function and having a chronic medical condition were also associated with more symptoms. 
  • Symptom burden increases the risk of poor physical performance. Researchers found that “older adults with a greater number of symptoms were weaker, slower and had poorer lower extremity physical performance at baseline than those with fewer symptoms.” They determined that older adults with more symptoms were not only physical weaker, they had an increased risk of falls, hospitalizations and disability. 
  • Pain and fatigue were the most common co-occurring symptoms. 
  • Symptoms slowed people down. Participants with any number of symptoms had slower gait speeds, compared with people without symptoms. 
  • A higher symptom count was associated with an increased risk of adverse outcomes, including mortality. 

What Can Healthcare Providers Do?

Overall, symptom burden among older adults is an important treatment target to prevent disability. The researchers assert that health care providers often focus on treating symptoms to improving quality of life when patients are receiving palliative care, but that more research is needed to evaluate whether improving symptom management among older free-living adults can help prevent or delay functional decline. 

Meanwhile, to improve symptoms and quality of life, encourage older patients to be as physically active as possible. The six symptoms examined—pain, fatigue, breathing difficulty, sleep difficult, anxiety and depression—”should be ameliorable with routine physical activity,” the authors wrote.

Last updated on 9/26/19.

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