Fatigue in patients with chronic disease: results from the population-based Lifelines Cohort Study

Abstract

Abstract(1) To evaluate the prevalence of severe and chronic fatigue in subjects with and without chronic disease; (2) to assess to which extent multi-morbidity contributes to severe and chronic fatigue; and (3) to identify predisposing and associated factors for severe and chronic fatigue and whether these are disease-specific, trans-diagnostic, or generic. The Dutch Lifelines cohort was used, including 78,363 subjects with (n = 31,039, 53 ± 12 years, 33% male) and without (n = 47,324, 48 ± 12 years, 46% male) ≥ 1 of 23 chronic diseases. Fatigue was assessed with the Checklist Individual Strength-Fatigue. Compared to participants without a chronic disease, a higher proportion of participants with ≥ 1 chronic disease were severely (23% versus 15%, p < 0.001) and chronically (17% versus 10%, p < 0.001) fatigued. The odds of having severe fatigue (OR [95% CI]) increased from 1.6 [1.5–1.7] with one chronic disease to 5.5 [4.5–6.7] with four chronic diseases; for chronic fatigue from 1.5 [1.5–1.6] to 4.9 [3.9–6.1]. Multiple trans-diagnostic predisposing and associated factors of fatigue were found, explaining 26% of variance in fatigue in chronic disease. Severe and chronic fatigue are highly prevalent in chronic diseases. Multi-morbidity increases the odds of having severe and chronic fatigue. Several trans-diagnostic factors were associated with fatigue, providing a rationale for a trans-diagnostic approach.

Does resilience predict hospital length of stay after total knee arthroplasty? A prospective observational cohort study

“…Our findings that high anesthetic risk score influences LOS is consistent with previous work [ 62 ]. Fatigue is a complex phenomenon, experienced by people with a wide range of chronic diseases and it incorporates disease-specific and psychosocial factors [ 63 ]. It is more highly correlated with the number of chronic diseases experienced rather than the severity of chronic disease [ 63 , 64 ].…”

“…Fatigue is a complex phenomenon, experienced by people with a wide range of chronic diseases and it incorporates disease-specific and psychosocial factors [ 63 ]. It is more highly correlated with the number of chronic diseases experienced rather than the severity of chronic disease [ 63 , 64 ]. The majority of our TKA cohort evidenced multimorbidity, yet few studies have explored fatigue in the TKA population, despite relatively high prevalence in people with osteoarthritis [ 64 , 65 ].…”

Toward unraveling the correlates of fatigue in glioma

“…These results corroborate studies in brain tumor patients that found no link between fatigue and tumor location, disease duration, type of neurosurgical intervention, and radiation [8][9][10] . Also in cancer survivors and patients with chronic disease, the persistence of fatigue is not determined by tumor-and treatment-related characteristics 11,[25][26][27] .…”

“…Dutch population-based study demonstrated that the prevalence of fatigue is similar across several chronic diseases, and is associated with factors such as depression, female sex, younger age, lower education level, neuroticism, self-consciousness, impulsivity, vulnerability, and pain 11 . We also found several PROMs to be associated with fatigue, unlike tumor-and treatment-related factors.…”

“…Even though the CIS questionnaire has a high test-retest reliability (r=0.74-0.86) 14 , the questionnaire is validated for use in groups and not in individuals per se. To compare, in the Dutch population,15% of the patients without chronic disease report severe fatigue based on the CIS-fatigue score 11 . So it’s evident, that the level of fatigue is much higher in glioma patients, compared to the general population.…”