A new study finds feeling fatigue could predict death in older adults

A new study finds feeling fatigue could predict death in older adults
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Feeling fatigued after certain activities can indicate that the occurrence of death is less than three years away in older people, new research has found.

Older people who scored the highest for feeling fatigued after activities were twice as likely to die in the following 2.7 years compared to their counterparts who scored lower. Fatigability was assessed during a selection of activities using the novel Pittsburgh Fatigability Scale.

The new study published in the Journal of Gerontology: Medical Sciences by the University of Pittsburgh is the first study to establish feeling fatigued after physical activity as an indicator of earlier mortality.

Feeling fatigued and physical activity

“This is the time of year when people make—and break—New Year’s resolutions to get more physical activity,” said lead author Nancy W. Glynn, PhD, associate professor in the Department of Epidemiology at Pitt’s Graduate School of Public Health. “I hope our findings provide some encouragement to stick with exercise goals. Previous research indicates that getting more physical activity can reduce a person’s fatigability. Our study is the first to link more severe physical fatigability to an earlier death. Conversely, lower scores indicate greater energy and more longevity.”

Glynn and her colleagues administered the Pittsburgh Fatigability Scale to 2,906 participants aged 60 or older in the Long Life Family Study, an international study that follows family members across two generations. Participants ranked from zero to five how prominent feeling fatigued would be after certain activities such as a leisurely 30-minute walk, light housework or heavy gardening.

Feeling fatigued is characterised by tiredness that is often overwhelming and is not relieved by sleep or rest. Certain health conditions are known to cause fatigue, such as anaemia, coeliac disease and diabetes.

What did the study find?

The follow-up for this work concluded at the end of 2019 to avoid any increased mortality impact from the COVID-19 pandemic, which gave the team an average of 2.7 years of data on each participant.

The research team accounted for a variety of factors that influence mortality, such as depression, pre-existing or underlying terminal illness, age and gender. The team found that participants who scored 25 points or higher on the Pittsburgh Fatigability Scale were 2.3 times more likely to die in the 2.7 years after completing the scale, compared to those who scored below 25.

“There has been research showing that people who increase their physical activity can decrease their fatigability score,” said Glynn, a physical activity epidemiologist. “And one of the best ways to increase physical activity—which simply means moving more—is by setting manageable goals and starting a routine, like a regular walk or scheduled exercise.”

Beyond linking feeling fatigue after activities to an earlier death, Glynn said the study demonstrates the value of the Pittsburgh Fatigability Scale, which she and colleagues created in 2014. It has since been translated into 11 languages.

“While the Pittsburgh Fatigability Scale has been widely adopted in research as a reliable, sensitive way to measure fatigability, it is underutilised in hospital settings and clinical trials,” Glynn said. “My ultimate goal is to develop a physical activity intervention targeting a reduction in fatigability as a means to stem the downward spiral of impaired physical function common with the ageing process. By reducing fatigability, one can change how they feel, potentially motivating them to do more.”


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