male doctor examining older adult woman's knee to determine cause of pain

Study Urges Doctors to Consider “Symptom Burden” in Older Patients

Margaret went to the doctor because her knee pain was worsening. The doctor ordered x-rays and increased Margaret’s dose of anti-inflammatory medication. Margaret never mentioned to the doctor that she had been feeling depressed lately, and that she’d been having trouble sleeping … yet both of those things can increase sensations of pain. And in turn, pain can increase depression and sleep problems!

Bottom line, when it comes to symptoms … it’s complicated!

A research team from the University of Washington conducted a study on “symptom burden”—the effect that various symptoms have, alone and together, on older patients. The study, published in the Journal of the American Geriatrics Society, urged doctors to pay more attention to the combined impact of symptoms on seniors and their quality of life.

Study author Prof. Kushang Patel and his team looked at the findings of the National Health and Aging Trends Study, which includes data from 7,500 seniors. They found that more than 50% of people older than 65 have two or more troublesome symptoms, and 25% have three or more. The number of symptoms increased with age. For the purpose of the study, the researchers defined “symptoms” as “negative health-related experiences reported by patients but not observed by clinicians.”

These six symptoms were the most common:

  • pain
  • fatigue
  • depression
  • anxiety
  • breathing difficulty
  • sleep problems

Sometimes symptoms are directly caused by an illness—for example, chest pain from heart problems, knee pain from arthritis, or breathing difficulty from to COPD. The causes of sleep problems and depression may be more complicated and there may be interplay between symptoms and various health problems. The American Geriatrics Society explains, “Older adults often experience more than one symptom at a time, which can make each symptom feel worse.”

Symptom burden was associated with increased falls, a higher rate of hospitalization, a loss of strength and function, and shorter life. Clearly treating symptoms is a big quality of life issue! Yet it often falls through the cracks as doctors focus on treating a particular disease or health condition.

The American Geriatrics Society notes that while palliative care specialists focus on symptom relief when patients are at the end of life, there is much more that can be done for all patients, as part of improved patient-centric, integrated care.

“Our results indicate that the overall burden of symptoms is something the clinician should consider, as it may have an impact that is not apparent when just dealing with diseases and symptoms individually, one at a time,” reported Prof. Patel. “For many older adults, symptoms often interfere with accomplishing daily activities. Addressing symptoms gives clinicians an opportunity to identify the patient’s goals and priorities, which can then help guide treatment decisions.”

The professional Life Care Managers at Holistic Aging believe that every older adult deserves the highest level of support for their own successful aging, no matter what challenges they encounter. We provide support and services to enhance the well-being of senior clients and families as they work together toward this goal.

Source: IlluminAge reporting on a study from the University of Washington and the American Geriatrics Society.

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