title: Symptom trajectory and symptom burden in older people with multimorbidity, secondary outcome from the RCT AGe-FIT study.
abstract: OBJECTIVE
  The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment.
  
  
  BACKGROUND
  Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity.
  
  
  METHODS
  Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial (AGe-FIT).
  
  
  METHODS
  Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011-2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care.
  
  
  RESULTS
  Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68-81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38-59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms.
  
  
  CONCLUSIONS
  Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms.
authors.affiliation: Department of Social and Welfare Studies, Faculty of Medicine and Health Sciences, Linkoping University, Sweden. jeanette.eckerblad@liu.se.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Eckerblad
authors.affiliation: Faculty of Health, Science and Technology, Department of Health Sciences, Nursing, Karlstad University, Sweden.
authors.forename: Kersti
authors.initials: K
authors.lastname: Theander
authors.affiliation: Department of Research and Education, Helsingborg Hospital, Sweden.|Division of Clinical Geriatrics, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Anne W
authors.initials: AW
authors.lastname: Ekdahl
authors.affiliation: Department of Social and Welfare Studies, Faculty of Medicine and Health Sciences, Linkoping University, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D008297:Male; D000076322:Multimorbidity; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012107:Research Design
keywords: community care; nurses; nursing; older people; quality of care; symptom management