Symptoms that restrict daily activities are common in the last year of an older person’s life and those restricting symptoms increase substantially about five months before death, according to a study by Sarwat I. Chaudhry, M.D., of the Yale University School of Medicine, New Haven, Conn., and colleagues.
The study enrolled 754 nondisabled, community-dwelling adults 70 years or older in 1998 and 1999, and of these, 491 died before June 30, 2011. The average age at death was almost 86 years. Researchers evaluated the monthly occurrence of physical and psychological symptoms that led to restrictions in daily activities.
The monthly occurrence of restricting symptoms was fairly constant from 12 months before death (20.4 percent) until five months before death (27.4 percent) when it increased rapidly and reached 57.2 percent in the month before death, according to the study results.
“Our results highlight the importance of assessing and managing symptoms in older patients, particularly those with multimorbidity,” the study concludes.
Commentary: Symptom Burden
In an invited commentary, Christine S. Ritchie, M.D., M.S.P.H., of the University of California, San Francisco, writes: “The article by Chaudhry et al serves as a call for two things: better palliative care for community – dwelling older adults at the end of life and better research.”
“Only through these efforts will we be able to relieve symptom burden for those older adults in greatest need of relief and be prepared for the increasing number of individuals with multimorbidity and the functional challenges that they experience,” Ritchie concludes.
Published online July 8, 2013. doi:10.1001/jamainternmed.2013.8732.
The work for this article was supported by a grant from the National Institute on Aging. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Published online July 8, 2013. doi:10.1001/jamainternmed.2013.6583.
The author made a conflict of interest and funding disclosure. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
JAMA Intern Med.