Nearly half of adults 65 and older have two or more of the following symptoms: pain, fatigue, depression, anxiety, breathing difficulty, sleep problems. And one in four older adults have three or more.
But these symptoms and the more serious health issues they may foreshadow are often missed by clinicians, often because patients discuss only one symptom per visit, a new study finds.
The findings are published in the Journal of the American Geriatrics Society.
“Our study shows that the report of multiple symptoms is common among older adults and increases the risk for a range of negative health outcomes over time, such as falls and hospitalization,” said lead author Dr. Kushang Patel, research associate professor in anesthesiology and pain medicine at the University of Washington School of Medicine.
The national study included 7,609 U.S. Medicare beneficiaries. The researchers assessed the participants’ annual physical performance during a six-year period and tracked the occurrence of falls, disability, hospitalization, nursing home admission, and mortality.
The study defined “symptoms” as negative health-related experiences reported by patients but not observed by clinicians. Symptoms account for most outpatient visits and are among the leading causes of disability, the researchers said.
And while many symptoms can be attributed to a specific disease or condition — such as chest pain with heart disease — they often have multiple causes and can reinforce each other.
For example, when older patients request to see a care provider about pain, they may also be experiencing fatigue and sleep difficulty, said Patel. In fact, those three symptoms are the most common triad, affecting 4.7 million older Americans, report the researchers.
“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,” Patel said.
“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.”
But this doesn’t mean that all Americans will struggle with symptoms as they age. A quarter of older Americans have none of these symptoms, Patel said.
But for the nearly 50 percent of older Americans who do experience two or more symptoms, the paper is a call to action in how health care is delivered for seniors, according to an accompanying editorial.
Patel hopes the new study will help drive efforts to improve patient-centered, integrated care for vulnerable older adults.