TY - JOUR
T1 - Frailty and Somatic Comorbidity in Older Patients With Medically Unexplained Symptoms
AU - Arts, Matheus H L
AU - Benraad, Carolien E M
AU - Hanssen, Denise
AU - Hilderink, Peter
AU - de Jonge, Linda
AU - Naarding, Paul
AU - Lucassen, Peter
AU - Oude Voshaar, Richard C
N1 - Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2019/9
Y1 - 2019/9
N2 - Objectives: To examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES). Design: Cross-sectional, comparative study.Design: Cross-sectional, comparative study.Setting: Community, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES.Participants: In total, 118 patients with MUS and 154 patients with MES, all aged >60 years.Methods: Frailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications.Results: Although patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation.Conclusions and implications: Despite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
AB - Objectives: To examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES). Design: Cross-sectional, comparative study.Design: Cross-sectional, comparative study.Setting: Community, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES.Participants: In total, 118 patients with MUS and 154 patients with MES, all aged >60 years.Methods: Frailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications.Results: Although patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation.Conclusions and implications: Despite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
KW - Frailty
KW - comorbidity
KW - medically unexplained
KW - MUS
KW - MES
KW - QUALITY-OF-LIFE
KW - LEUKOCYTE TELOMERE LENGTH
KW - SOMATOFORM DISORDERS
KW - DSM-IV
KW - PREVALENCE
KW - SOMATIZATION
KW - VALIDATION
KW - INTERVIEW
KW - ANXIETY
KW - HEALTH
U2 - 10.1016/j.jamda.2019.02.015
DO - 10.1016/j.jamda.2019.02.015
M3 - Article
C2 - 30954419
SN - 1525-8610
VL - 20
SP - 1150
EP - 1155
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 9
ER -