title: Interrelationships among common symptoms in the elderly and their effects on health-related quality of life: a cross-sectional study in rural Korea.
abstract: BACKGROUND
  Because the world population is aging, it has become increasingly important to focus on and meet the healthcare needs of elderly individuals. This study aims to evaluate the relationships among common symptoms experienced by the elderly, including fatigue, pain, sleep disturbance, indigestion, and depression/anger/anxiety, and to assess how these symptoms affect health-related quality of life (HRQoL) in the elderly population after adjusting for sociodemographic characteristics and diagnosed diseases.
  
  
  METHODS
  In a cross-sectional study conducted in 2014 in a rural area of Korea, we extracted data on 1328 elderly individuals aged 60 years or older. Their HRQoL was assessed using the EuroQol Five-Dimension (EQ-5D) questionnaire. The pairwise associations between each symptom and the influence of the symptoms on HRQoL were measured using logistic regression and multiple regression analysis.
  
  
  RESULTS
  Each symptom was positively correlated with the other symptoms. The strongest association was observed between fatigue and pain (adjusted odds ratio = 8.127), and the weakest correlation was observed between sleep and indigestion (adjusted odds ratio = 2.521). Of the individuals experiencing symptoms other than sleep disturbance, those who reported comorbid symptoms tended to report higher symptom severity and a higher prevalence of symptoms persisting for ≥ 3 days compared with individuals who reported only one symptom. The number of symptoms was significantly correlated with the EQ-5D index (Spearman correlation coefficient = -0.370, p < 0.01) and the EQ Visual Analog Scale (EQ VAS) scores (Spearman correlation coefficient = -0.226, p < 0.01). Fatigue, pain, and sleep disturbance showed negative effects on all dimensions of EQ-5D. In multiple regression analysis, fatigue (β = -0.073, p < 0.01), pain (β = -0.140, p < 0.01), sleep disturbance (β = -0.061, p < 0.05), and depression/anger/anxiety (β = -0.065, p < 0.05) showed significant independent effects on the EQ-5D index when we adjusted for socioeconomic characteristics and diagnosed diseases.
  
  
  CONCLUSIONS
  Fatigue, pain, sleep disturbance, and depression/anger/anxiety were correlated with one another, and they presented significant independent effects on the HRQoL of elderly individuals. Thus, multidisciplinary healthcare programs are required to address these common symptoms.
authors.affiliation: Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 305-811, Republic of Korea.
authors.forename: Sujeong
authors.initials: S
authors.lastname: Mun
authors.affiliation: Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 305-811, Republic of Korea.
authors.forename: Kihyun
authors.initials: K
authors.lastname: Park
authors.affiliation: Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 305-811, Republic of Korea.
authors.forename: Younghwa
authors.initials: Y
authors.lastname: Baek
authors.affiliation: Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 305-811, Republic of Korea.
authors.forename: Siwoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: Mibyeong Research Center, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 305-811, Republic of Korea. jhyoo@kiom.re.kr.
authors.forename: Jong-Hyang
authors.initials: JH
authors.lastname: Yoo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000628:therapy*; D005221:Fatigue / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000451:nursing*; D015995:Prevalence; D011788:Quality of Life; D056910:Republic of Korea / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000628:therapy*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Depression; Elderly; Fatigue; Health-related quality of life; Indigestion; Pain; Sleep disturbance