Fatigue Among Elders Tied to Other Ills

Aug. 8, 2008 -- A study done by researchers at Columbia University urges physicians to take complaints of exhaustion among the elderly seriously.

There were 2,130 people in the study, which took place from 1989 to 1995. The average age was 74, and 20% of the participants were older than 80. The majority were women.

The participants were all 65 years old or older and all living in a "target area" north of 150th Street in Manhattan.

Study authors, led by Huai Cheng at Columbia University, write, "Poverty, crime, and unemployment rates are high in the study target area."

Of the participants, 33% were African-American, 47% were Latino, and 20% were white.

They were evaluated at a baseline in 1989 and checked on every 18 months after that to 1995.

Fatigue Among Elderly

• "Do you sit around a lot because of a lack of energy" or have you "felt slowed physically in the past month?"
• Have you "recently not had enough energy," do you "wake up tired," or nap more than two hours a day?

The study members rated features of their physical and mental health.

They also were asked how much they used health care facilities.

Results

• A lack of energy (or anergia) was more common in women than men. Twenty-two percent of the women reported having a lack of energy, compared with 12% of the men.
• People with a lack of energy had higher death rates than those who did not have anergia during the study period.
• Those with a lack of energy were more often not married (21% compared to 13%) than married, and older.

Lack of energy was linked to poorer reported health and physical function, such as being able to walk fewer blocks before needing to rest and more limited ability to perform activities of daily living.

Having lack of energy also was more likely to be linked to having joint problems, needing to take pain drugs, urinary incontinence, hearing problems, depression, and social isolation.

• People with a lack of energy went to hospitals more often than those who were not exhausted, which included trips to the emergency room, office visits, and all home care health services.

Study author Mathew Maurer, MD, says doctors need to listen beyond complaints of fatigue.

"When elderly patients complain they're tired, most doctors say, 'yeah, well, you're old," says Maurer in a prepared statement.

"They tell their patients that feeling listless is an expected part of aging, but there are reasons people are tired and they need to be investigated. For clinicians, the message from our study is that a lack of energy is widespread in the elderly, but it's not normal."

In background information published with the findings, study authors write that a lack of energy makes up what they call a "geriatric syndrome," like memory problems or falling.

A lack of energy may also be associated with heart disease, problems with the kidneys or lungs, depression, arthritis, and anemia.

In a news release, study co-author Barry Gurland, MD, says it's important to explore what happens as we age.

"Unraveling the causes of anergia will expand the scope of geriatric interventions that enable aging persons to preserve their quality of life."

Gurland is director of the Columbia University Stroud Center for the Studies of Quality of Life.

The findings are published in the Journal of Gerontology.