BACKGROUND: Little is known about the frequency and range of symptoms experienced by community-dwelling older persons with advanced chronic disease who are not enrolled in hospice. The objectives of our study were to determine (1) the prevalence of a range of symptoms among older persons with advanced chronic disease and (2) whether the prevalence of symptoms is similar across diagnoses. METHODS: This was a cross-sectional study of the symptoms reported by 226 community-dwelling persons 60 years or older with advanced chronic obstructive pulmonary disease (COPD), cancer, or congestive heart failure (CHF). Symptoms were assessed using the Edmonton Symptom Assessment System. RESULTS: Virtually all participants (86%) experienced at least 1 symptom that rated moderate or severe, and most (69%) experienced 2 or more symptoms. The symptoms reported by the greatest proportion of participants were limited activity (61%), fatigue (47%), and physical discomfort (38%). Participants with COPD had a higher unadjusted mean +/- SD number of moderate or severe symptoms (3.3 +/- 2.1) than did participants with cancer (2.6 +/- 1.8; P = .03) or CHF (2.0 +/- 1.7; P<.001). After we adjusted for sociodemographic factors, compared with participants with CHF, participants with cancer experienced 38% (95% confidence interval, 9%-75%) more moderate or severe symptoms and participants with COPD experienced 71% (95% confidence interval, 37%-114%) more moderate or severe symptoms. CONCLUSIONS: Most community-dwelling older persons with advanced COPD, cancer, or CHF experienced multiple moderate or severe symptoms. The clinical care of community-dwelling older persons with advanced chronic illnesses would be enhanced by the identification and alleviation of the range of symptoms they experience.
BACKGROUND: Little is known about the frequency and range of symptoms experienced by community-dwelling older persons with advanced chronic disease who are not enrolled in hospice. The objectives of our study were to determine (1) the prevalence of a range of symptoms among older persons with advanced chronic disease and (2) whether the prevalence of symptoms is similar across diagnoses. METHODS: This was a cross-sectional study of the symptoms reported by 226 community-dwelling persons 60 years or older with advanced chronic obstructive pulmonary disease (COPD), cancer, or congestive heart failure (CHF). Symptoms were assessed using the Edmonton Symptom Assessment System. RESULTS: Virtually all participants (86%) experienced at least 1 symptom that rated moderate or severe, and most (69%) experienced 2 or more symptoms. The symptoms reported by the greatest proportion of participants were limited activity (61%), fatigue (47%), and physical discomfort (38%). Participants with COPD had a higher unadjusted mean +/- SD number of moderate or severe symptoms (3.3 +/- 2.1) than did participants with cancer (2.6 +/- 1.8; P = .03) or CHF (2.0 +/- 1.7; P<.001). After we adjusted for sociodemographic factors, compared with participants with CHF, participants with cancer experienced 38% (95% confidence interval, 9%-75%) more moderate or severe symptoms and participants with COPD experienced 71% (95% confidence interval, 37%-114%) more moderate or severe symptoms. CONCLUSIONS: Most community-dwelling older persons with advanced COPD, cancer, or CHF experienced multiple moderate or severe symptoms. The clinical care of community-dwelling older persons with advanced chronic illnesses would be enhanced by the identification and alleviation of the range of symptoms they experience.
Authors: Karen E Steinhauser; Robert M Arnold; Maren K Olsen; Jennifer Lindquist; Judith Hays; Laura L Wood; Allison M Burton; James A Tulsky Journal: J Pain Symptom Manage Date: 2011-01-28 Impact factor: 3.612
Authors: Mary E Tinetti; Gail J McAvay; Sandy S Chang; Anne B Newman; Annette L Fitzpatrick; Terri R Fried; Peter N Peduzzi Journal: J Am Geriatr Soc Date: 2011-08-30 Impact factor: 5.562
Authors: Amy S Kelley; Partha Deb; Qingling Du; Melissa D Aldridge Carlson; R Sean Morrison Journal: Health Aff (Millwood) Date: 2013-03 Impact factor: 6.301
Authors: Joy R Goebel; Lynn V Doering; Lorraine S Evangelista; Adeline M Nyamathi; Sally L Maliski; Steven M Asch; Cathy D Sherbourne; Lisa R Shugarman; Andy B Lanto; Angela Cohen; Karl A Lorenz Journal: J Card Fail Date: 2008-11-13 Impact factor: 5.712
Authors: David B Bekelman; John S Rumsfeld; Edward P Havranek; Traci E Yamashita; Evelyn Hutt; Sheldon H Gottlieb; Sydney M Dy; Jean S Kutner Journal: J Gen Intern Med Date: 2009-03-14 Impact factor: 5.128