Chronic symptoms in a representative sample of community-dwelling older people: a cross-sectional study in Switzerland

Abstract

ObjectivesThe burden of multiple diagnoses is well documented in older people, but less is known about chronic symptoms, many of which are even not brought to medical attention. This study aimed to determine the prevalence of chronic symptoms, their relationships with disability in basic activities of daily living (BADL) and quality of life (QoL), and their public health impact.DesignA large cross-sectional population-based study.SettingCommunity in 2 regions of French-speaking Switzerland.ParticipantsCommunity-dwelling older adults aged 68 years and older in 2011 (N=5300).OutcomesDisability in BADL defined as difficulty or help needed with any of dressing, bathing, eating, getting in/out of bed or an arm chair, and using the toilet. Overall QoL dichotomised as favourable (ie, excellent or very good) or unfavourable (ie, good, fair or poor). Disturbance by any of the following 14 chronic symptoms for at least 6 months: joint pain, back pain, chest pain, dyspnoea, persistent cough, swollen legs, memory gaps, difficulty concentrating, difficulty making decisions, dizziness/vertigo, skin problems, stomach/intestine problems, urinary incontinence and impaired sexual life.ResultsOnly 17.1% of participants did not report being disturbed by any of these chronic symptoms. Weighted prevalence ranged from 3.1% (chest pain) to 47.7% (joint pain). Most chronic symptoms were significantly associated with disability in BADL or unfavourable QoL, with substantial gender differences. The number of chronic symptoms was significantly associated with disability in BADL and unfavourable QoL, with gradients suggesting dose–response relationships. Joint pain and back pain had the highest population attributable fractions.ConclusionsChronic symptoms are highly prevalent in older people, and are associated with disability in BADL and unfavourable QoL, particularly when multiple chronic symptoms co-occur. Owing to their high public health impact, musculoskeletal chronic symptoms represent good targets for preventive interventions.

Symptom Burden Among Community‐Dwelling Older Adults in the United States

“…The current study findings are consistent with prior studies on symptoms in older adults that have examined cross-sectional associations with physical functioning as well as prospectively examined the risk of hospitalization and nursing home admission. [14][15][16][17][18] However, in contrast to previous studies with symptom counts ranging between 10 and 20, [14][15][16][17][18] the current study focused on six common physical and psychological symptoms. Although other symptoms, such as self-reported weakness or balance problems, are collected in the NHATS and were used in previous studies, we chose not to include them because we planned to investigate mobility-related functional outcomes.…”

“…21,22,27,49 In addition, the NHATS symptom questions are generally similar to ones used in previous studies of symptom burden in older adults. [14][15][16][17][18] A second limitation is that symptom reports are subject to recall bias. Other study limitations include the absence of data on disease severity or on medications, which can cause symptoms through adverse effects, and polypharmacy might be an important unmeasured confounder.…”

Chronic pain and geriatric syndromes in community-dwelling patients aged ≥65 years

“…Similar results have been reported in the past 28 , 43 and they may be related to problems in the diagnosis of pain 44 , 45 on the part of both the patients and the physicians and poor patient–doctor concordance in evaluation of the pain. 12 These findings are of great concern since, according to the results of a recently published study, 7 direct intervention in the treatment of joint pain can, theoretically, reduce functional impairment.…”

“…Many studies have investigated associations between pain and specific GS, such as functional limitations, 6 , 7 , 9 , 11 – 15 affective disorders, 6 , 10 , 14 , 16 – 26 cognitive decline, 27 – 30 and falls. 12 However, a literature review on the association between pain and GS and their mutual effect on outcomes, such as mortality, functional decline, falls, etc., did not yield a clear-cut picture.…”

Chronic Pain and Related Factors in Patients Aged ≥80 Years

“…Our study does not suggest an association between dependence in ADL and chronic pain. There are studies showing relationship between disability in ADL and chronic pain (40,41); but those were not specifically carried out on "oldest" people. We know that the prevalence of dependence in ADL increases with old age; and our study population consists of individuals older than 80 years who already had increased rates of comorbidities and baseline functional limitations, independent of pain factor.…”