For older adults with chronic conditions, non-drug behavioral treatments may help

When we have several chronic health conditions as we age, the symptoms we experience can reduce our quality of life. In fact, having multiple chronic conditions is linked to symptoms that can restrict our ability to perform our daily routines. Some 70 percent of adults over the age of 75 have more than two chronic health conditions. Nearly 55 percent of Medicare recipients who have had a stroke or heart failure have five or more chronic conditions.

In a study published in the Journal of the American Geriatrics Society, researchers note that little is known about treating symptoms of multiple illnesses because people with two or more conditions are usually excluded from studies for specific diseases.

The researchers examined the results of a study that was originally designed to test how well people did after they stopped taking statin medication used to lower cholesterol levels. Their goal was to better understand the outcomes of having multiple diseases, the burden that symptoms placed on older adults, and the effects multiple chronic problems had on older adults' ability to function. In addition, the researchers compared how a having diagnosis of cancer to having multiple chronic conditions affected an older adult's ability to function.

The study had 381 participants, mostly in their 70s. Nearly 52 percent of study participants had been diagnosed with cancer. People without cancer were diagnosed with COPD (chronic obstructive pulmonary disease, a long-term illness in which breathing becomes more and more of a challenge), congestive heart failure, dementia, renal disease (diseases that affect the kidney), and other chronic illnesses. Most commonly, the participants had combinations of COPD, congestive heart failure, and cardiovascular disease.

The researchers learned that having multiple chronic conditions was linked to symptoms that could be a burden for people. However, the symptoms did not affect their ability to function. Researchers also learned that people with cancer functioned better than people with multiple chronic conditions.

The researchers concluded that the total sum of symptoms, rather than the combination of chronic conditions, was linked to an older adult's ability to function well. They suggested that specific symptoms, such as depression and fatigue, might be responsible for the effect symptoms had on a person's ability to function well. Depression and fatigue were proven to worsen other symptoms, note the researchers.

"Our findings support the growing evidence recommending a shift from disease-specific treatment to addressing the symptoms that result from having multiple chronic conditions," wrote the researchers.

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This summary is from "High Symptom Burden and Low Functional Status in The Setting of Multimorbidity". It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Jennifer Dickman Portz, PhD, MSW; Jean S. Kutner, MD, MSPH; Patrick J. Blatchford, PhD; and Christine S. Ritchie, MD, MSPH.

This research summary was developed as a public education tool by the Health in Aging Foundation. The Foundation is a national non-profit established in 1999 by the American Geriatrics Society to bring the knowledge and expertise of geriatrics healthcare professionals to the public. We are committed to ensuring that people are empowered to advocate for high-quality care by providing them with trustworthy information and reliable resources. Last year, we reached nearly 1 million people with our resources through HealthinAging.org. We also help nurture current and future geriatrics leaders by supporting opportunities to attend educational events and increase exposure to principles of excellence on caring for older adults. For more information or to support the Foundation's work, visit http://www.HealthinAgingFoundation.org.

Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.

Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals that has--for 75 years--worked to improve the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit AmericanGeriatrics.org.