Chronic Illnesses and Fatigue in Older Individuals: A Literature Review

Abstract

In the United states, 60% of adults have one chronic disease and 40% have at least two chronic diseases. Fatigue is a commonly reported symptom in individuals with chronic illnesses, the prevalence of which ranges between 40-74%. It is associated with multiple risk factors and has a tremendous impact on quality of life, social functioning, mood, motivation and cognition. Despite its high prevalence, the relationship between fatigue and chronic illness has not been well explored. Accordingly, the focus of this synthesis of literature is to explore fatigue-associated factors and their relation to chronic disease. The databases searched were CINAHL, PubMed, PsychInfo and Web of Science, where the following keywords were used: “Chronic disease” OR “Chronic illness” OR “Chronic conditions”, “Fatigue”, “Elderly” OR “Older adults” OR “Seniors” OR “Geriatrics”. The synthesis resulted in four themes: understanding the concept of fatigue, factors related to fatigue, activity and fatigue, and self-management of fatigue. There were some inconsistencies in the findings among research studies which were addressed, in addition to the strengths and weaknesses of some of the fatigue measurement scales used. This literature review integrates findings about fatigue in chronic illnesses in various aspects, in the population of individuals who are of 65 age or older. The four emerged themes are of value to individuals with similar characteristics as the selected population, as well as to health care providers and researchers who may address the inconsistent findings and provide a strong evidence for best practice.

Prevalence and correlates of fatigue and its association with quality of life among clinically stable older psychiatric patients during the COVID-19 outbreak: a cross-sectional study

“…First, fatigue is a comorbid symptom of many psychiatric diagnoses. For instance, a study found that 60% of psychiatric inpatients reported significant level of fatigue [53], particularly those with depressive or anxiety disorders [50]. Although patients were clinically stable during the study period, the COVID-19 outbreak and related problems such as limited access to psychiatric services and fear of transmission could have triggered certain comorbid symptoms such as fatigue, in these patients.…”

“…Due to the suspension of public transportation and mass quarantine measures, this group may have had more difficulty attending follow-up appointments and receiving maintenance treatments, in other diagnoses included bipolar disorder, schizophrenia, organic mental disorders, etc. P-P plots revealed that among the six continuous variables (e.g., age, education years, PHQ-9 total score, ISI total score, pain total score, and overall QOL), age and overall QOL scores were normally distributed but other continuous variables had skewed distributions turn, exacerbating their physical illnesses (e.g., cancer, hypertension, chronic pain disorder, chronic obstructive pulmonary disease) and experience of fatigue [50,51]. Third, sedentary lifestyle, due to lack of physical exercise, was associated with fatigue [38].…”

Prevalence and Correlates of Fatigue and Its Association with Quality of Life Among Clinically Stable Older Psychiatric Patients During the COVID-19 Outbreak: A Cross-Sectional Study

“…First, fatigue is a comorbid symptom of many psychiatric diagnoses. For instance, a study found that 60% of psychiatric inpatients reported signi cant level of fatigue (Waters et al, 2013), particularly those with depressive or anxiety disorders (Torossian et al, 2020). Although patients were clinically stable during the study period, the COVID-19 outbreak and related problems such as limited access to psychiatric services and fear of transmission could have triggered certain comorbid symptoms such as fatigue, in these patients.…”

“…Second, many older adults suffered from severe and/or chronic physical illnesses. Due to the suspension of public transportation and mass quarantine measures, this group may have had more di culty attending follow-up appointments and receiving maintenance treatments, in turn, exacerbating their physical illnesses (e.g., cancer, hypertension, chronic pain disorder, chronic obstructive pulmonary disease) and experience of fatigue (Torossian et al, 2020;Tralongo et al, 2003). Third, a lack of access to outdoor activities and physical exercises due to quarantine measures during the COVID-19 pandemic could cause fatigue (Marin et al, 2004).…”

Prevalence and correlates of fatigue and its association with quality of life among clinically stable older psychiatric patients during the COVID-19 outbreak: A cross-sectional study

“…Second, many older adults suffered from severe and/or chronic physical illnesses. Due to the suspension of public transportation and mass quarantine measures, this group may have had more di culty attending follow-up appointments and receiving maintenance treatments, in turn, exacerbating their physical illnesses (e.g., cancer, hypertension, chronic pain disorder, chronic obstructive pulmonary disease) and experience of fatigue (Torossian & Jacelon, 2020;Tralongo et al, 2003). Third, sedentary lifestyle, due to lack of physical exercise, was associated with fatigue (Marin & Menza, 2004).…”