title: [Functional decline and presence of symptoms in palliative care: Cause or consequence?]
abstract: BACKGROUND
  Several publications have related functional decline to the appearance of symptoms, especially psychiatric or psychological ones, such as anxiety and depression. Moreover, an initial depressive disorder or prior to functional decline usually worsens it. It was decided to investigate the relationship between the presence of functional decline, measured by a decrease in the Barthel index (BI), and the presence of symptoms.
  
  
  METHODS
  A prospective analytical study conducted on patients referred to a Home Care Support Team (HCST).
  
  
  RESULTS
  The study included 638 cases, of which 53.9% (N=344) were male, 56% (N=357) with cancer and 44% (N=281) geriatric. The mean age was 79.64 years+- 10.8. Significant differences (P<.001) were found in functional decline measured by mean decline in the BI between cancer (34.4) and non-cancer patients (12.12). Significant differences (P<.001) were also found in all recorded symptoms (pain, dyspnoea, anorexia, nausea, anxiety, depression, and insomnia), more frequently in cancer patients, except psychomotor agitation. A higher presence of symptoms was detected in patients with greater functional decline, with decreases in BI above 20 points. There were no differences in previous treatments, except in certain analgesics. Differences were found in the different treatments prescribed by HCST.
  
  
  CONCLUSIONS
  The presence of functional decline and its level may be related to the appearance of symptoms, especially in cancer patients.
authors.affiliation: Unidad de Valoración Sociosanitaria y Equipo de Soporte Hospitalario de Cuidados Paliativos, Servicio de Geriatría, Hospital de Barbastro, Huesca, España. Electronic address: alzamur@gmail.com.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Zamora-Mur
authors.affiliation: Equipo de Soporte Hospitalario de Cuidados Paliativos, Hospital Arnau de Vilanova, Lérida, España.
authors.forename: María
authors.initials: M
authors.lastname: Nabal-Vicuña
authors.affiliation: Servicio de Especialidades Médicas, Hospital de Barbastro, Huesca, España.
authors.forename: Aranzazu
authors.initials: A
authors.lastname: Zamora-Catevilla
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: García-Foncillas
authors.affiliation: Servicio de Oncología Médica, Hospital de Barbastro, Huesca, España.
authors.forename: Verónica
authors.initials: V
authors.lastname: Calderero-Aragón
authors.affiliation: Departamento de Biomedicina, Universidad de Bergen, Bergen, Noruega.
authors.forename: Óscar
authors.initials: Ó
authors.lastname: Aubí-Catevilla
authors.affiliation: Departamento de Anatomía e Histología Humanas, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Lostalé-Latorre
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000075902:Clinical Deterioration; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy; D010166:Palliative Care; D011446:Prospective Studies; D063189:Symptom Assessment
keywords: Cuidados paliativos; Declive funcional; Functional decline; Oncology; Oncológico; Palliative care; Symptoms; Síntomas