Chronic Illness and Fatigue in Older Individuals: A Systematic Review

Torossian, Maral; Jacelon, Cynthia S.

doi:10.1097/rnj.0000000000000278

Cited by 19 publications

(12 citation statements)

References 38 publications

(95 reference statements)

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“…Recently, it was suggested that several factors underlying fatigue were similar for multiple non-communicable chronic diseases, including female gender, younger age, higher BMI, being a current smoker, increased resting heart rate, reduced motivation, symptoms of anxiety and/or depression, pain, sleep disturbances, limitations in physical functioning and not being involved in leisure-time sports activities [ 4 , 5 ]. This provides a basis for using a trans-diagnostic approach for the management of fatigue in non-communicable chronic diseases rather than interventions tailored to specific chronic diseases [ 4 , 5 , 25 ]. To date, fatigue management interventions including cognitive behavioural therapy and/or exercise therapy appear to be the most promising across different diseases, for example rheumatoid-arthritis [ 26 ], COPD [ 27 ], type 1 diabetes mellitus [ 28 ], multiple sclerosis [ 29 ] and end-stage renal failure [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Physical and mental fatigue in people with non-communicable chronic diseases

et al. 2022

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Background Fatigue is frequently reported in people with a non-communicable chronic disease. More insight in the nature of this symptom may enhance targeted treatment of fatigue. In this study, we aimed to gain more insight in the prevalence of different types of fatigue and in current prescribed treatment strategies to reduce fatigue in non-communicable chronic diseases. Methods People with non-communicable chronic diseases were contacted via public, non-profit, disease-specific health funds and patient associations and invited to complete a web-based survey. The survey included a general question about the experience (“Do you now or have you ever had complaints of fatigue?”) and nature of fatigue (physically/mentally/combination), the Checklist Individual Strength-subscale subjective fatigue (CIS-Fatigue; 8–56 points), self-constructed questions for the distinction between physical and mental fatigue (both 3–21 points) and questions on prescribed treatments for fatigue. Results In total, 4199 participants (77% females) completed the online survey. 3945 participants (94.0%) reported experiencing fatigue, of which 64.4% reported a combination of both physical and mental fatigue. Median CIS-Fatigue score was 41 (32–48) points, with 68% of the participants reporting severe fatigue (≥36 points). Median scores for physical and mental fatigue were 15 (11–18) and 12 (8–16) points, respectively. In 55% of the participants, fatigue was only occasionally or never discussed with the healthcare professional, and only 23% of the participants were prescribed a treatment for fatigue. Participants often reported no effect or even an increase in fatigue after treatment. Conclusions Findings indicate that both physical and mental fatigue are often experienced simultaneously in people with non-communicable chronic diseases, but can also occur separately. Fatigue is often only occasionally or never discussed, let alone treated, highlighting the need to raise awareness among healthcare professionals. Future studies are needed to gain more insight in underlying factors of fatigue in non-communicable chronic diseases, its impact on daily life and development and evaluation of targeted treatment strategies. Key messages: Both physical and mental fatigue are frequently present in people with non-communicable chronic diseases. Fatigue is often only occasionally or never discussed during consultation with the physician, highlighting the need to raise awareness among healthcare professionals for adequate screening and evaluating of fatigue in people with non-communicable chronic diseases. Only less than a quarter of the people with non-communicable chronic diseases who reported to experience fatigue were prescribed a treatment for fatigue, which was often experienced as ineffective.

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Section: Discussionmentioning

confidence: 99%

Physical and mental fatigue in people with non-communicable chronic diseases

et al. 2022

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“…Chronic fatigue was also significantly associated with increased odds of depressive symptoms among OALWH in our study, similar to what has been reported elsewhere [ 65 , 66 ]. Fatigue is a vital indicator of ageing‐related declines in health and functioning [ 67 ]. Fatigue management strategies, such as adequate rest and sleep, are likely to improve the mental health of OALWH.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with mild depressive and anxiety symptoms in older adults living with HIV from the Kenyan coast

et al. 2022

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Introduction Empirical research on the burden and determinants of common mental disorders (CMDs), especially depression and anxiety, among older adults living with HIV (OALWH) in sub‐Saharan Africa is inadequate. To bridge the gap in Kenya we: (1) determined the prevalence of CMDs among OALWH on routine HIV care compared to HIV‐negative peers; (2) investigated HIV status as an independent predictor of CMDs in older adults; and (3) investigated CMD determinants. Methods In a cross‐sectional study conducted between 2020 and 2021, the prevalence of CMDs and associated determinants were investigated at the Kenyan coast among 440 adults aged ≥50 years (257 OALWH). The Patient Health Questionnaire and Generalized Anxiety Disorder scale were administered alongside measures capturing biopsychosocial information. Logistic regression was used to examine the correlates of CMDs. Results No significant differences were found in the prevalence of mild depressive symptoms, 23.8% versus 18.2% (p = 0.16) and mild anxiety symptoms, 11.7% versus 7.2% (p = 0.12) among OALWH compared to HIV‐negative peers, respectively. HIV status was not independently predictive of CMDs. Among OALWH, higher perceived HIV‐related stigma, ageism, increasing household HIV burden, loneliness, increasing functional disability, sleeping difficulties, chronic fatigue and advanced age (>70 years) were associated with elevated CMDs. Among HIV‐negative older adults, loneliness, increased medication burden and sleeping difficulties were associated with elevated depressive symptoms. Easier access to HIV care was the only factor associated with lower CMDs among OALWH. Conclusions On the Kenyan coast, the burden of moderate and severe CMDs among older adults is low; however, both OALWH and their HIV‐negative peers have a similar relatively high burden of mild depressive and anxiety symptoms. Our results also suggest that determinants of CMDs among OALWH in this setting are predominantly psychosocial factors. These results highlight the need for psychosocial interventions (at the family, community and clinical levels) to mitigate the risks of mild CMDs as they are known to be potentially debilitating.

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“…The accompanying dysregulation of body homeostasis in the elderly leads to impaired gastrointestinal iron absorption and decreased iron availability due to inflammation and increased hepcidin levels [ 79 ]. Finally, the lack of iron supplementation among these individuals could exaggerate the iron deficiency in the body [ 80 ]. Neidlein et al conducted a study among 224 individuals aged 65–95 years who were hospitalized for various reasons [ 42 ].…”

Section: Clinical Presentation Of Iron Disturbancesmentioning

confidence: 99%

Chronic Fatigue Syndrome in Patients with Deteriorated Iron Metabolism

et al. 2022

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Fatigue is a common, non-specific symptom that often impairs patients’ quality of life. Even though fatigue may be the first symptom of many serious diseases, it is often underestimated due to its non-specific nature. Iron metabolism disorders are a prominent example of conditions where fatigue is a leading symptom. Whether it is an iron deficiency or overload, tiredness is one of the most common features. Despite significant progress in diagnosing and treating iron pathologies, the approach to chronic fatigue syndrome in such patients is not precisely determined. Our study aims to present the current state of knowledge on fatigue in patients with deteriorated iron metabolism.

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Chronic Illness and Fatigue in Older Individuals: A Systematic Review

Cited by 19 publications

References 38 publications

Physical and mental fatigue in people with non-communicable chronic diseases

Physical and mental fatigue in people with non-communicable chronic diseases

Prevalence and factors associated with mild depressive and anxiety symptoms in older adults living with HIV from the Kenyan coast

Chronic Fatigue Syndrome in Patients with Deteriorated Iron Metabolism

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