Fatigue predicts mortality in older adults.
OBJECTIVE
To determine the association between fatigue and survival over 10 years in a population of older community-dwelling primary care patients.


METHODS
Prospective cohort study.


METHODS
Medicare health maintenance organization and Veterans Affairs primary care programs.


METHODS
Older primary care patients (N=492).


METHODS
Fatigue, operationalized as feeling tired most of the time, was assessed at baseline. Mortality was ascertained from the National Death Index. Covariates included demographics, comorbidity, cognitive function, depressive symptoms, body mass index, self-rated health, functional status, and gait speed.


RESULTS
Mortality rates at 10 years were 59% (123/210) for older adults with fatigue, versus 38% (106/282) for those without fatigue (P<.001). After adjustment for multiple potential confounders, participants who were tired at baseline had a greater risk of death than those who were not (hazard ratio=1.44, 95% confidence interval=1.08-1.93).


CONCLUSIONS
A single simple question "Do you feel tired most of the time?" identifies older adults with a higher risk of mortality. Further research is needed to identify and characterize the underlying mechanisms of fatigue, to develop and test specific treatments, and to determine whether improvement leads to decreased morbidity and mortality.
Hardy
Susan E
SE
Division of Geriatric Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA. hardys@dom.pitt.edu
Studenski
Stephanie A
SA
D000368:Aged; D005221:Fatigue; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D018570:Risk Assessment; D016019:Survival Analysis