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Studies Examine Late-Life Disability, Restricting Symptoms

Occurrence of restricting symptoms increases five months before death; up with multimorbidity

TUESDAY, July 9 (HealthDay News) -- Disability at two years before death is more likely for those who die at older ages; and restrictions in daily activities are common in the last year of life, increasing considerably five months before death, according to two studies published online July 8 in JAMA Internal Medicine.

Alexander K. Smith, M.D., M.P.H., from the University of California in San Francisco, and colleagues estimated disability in the last two years of life using data from 8,232 participants who died while enrolled in the Health and Retirement Study. The researchers found that the prevalence of disability increased from 28 percent at two years before death to 56 percent in the final month of life. Disability at two years before death was more likely among those who died at the oldest ages, and for women versus men.

Sarwat I. Chaudhry, M.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues examined the monthly occurrence of physical and psychological symptoms leading to restrictions in daily activities during the last year of life among 754 older individuals (aged 70 years or older). The researchers found that the monthly occurrence of restricting symptoms was stable from 12 months before death (20.4 percent) to five months before death (27.4 percent) and increased thereafter to 57.2 percent in the month before death. The odds of monthly occurrence of symptoms were increased with age younger than 85 years, multimorbidity, and proximity to time of death.

"Our results highlight the importance of assessing and managing symptoms in older patients, particularly those with multimorbidity," Chaudhry and colleagues write.

Abstract - Smith
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Abstract - Chaudhry
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