Lack of Energy in Old Age Might Not Just Be Normal Part of Aging
"Old and tired" is such a common phrase that it's no surprise that a new study in the Journal of Gerontology has found that almost one in five senior citizens report they have so little energy that they spend most of the day sitting on the sofa.
But even though a lack of energy is common in the elderly, the study's authors say that physicians should take their patients' reports more seriously, because the study also showed that a lack of energy—a condition called anergia—is linked to several health problems and greater rates of hospitalization and death. The authors state that anergia constitutes a geriatric syndrome similar to other common syndromes associated with aging such as falling and memory impairments.
Lack of energy is just "a part of getting old," right? Think again! Feeling tired may indicate a treatable underlying condition.
"When elderly patients complain they're tired, most doctors say, 'yeah, well, you're old,' " says Mathew Maurer, M.D., associate professor of Clinical Medicine at Columbia University Medical Center. "They tell their patients that feeling listless is an expected part of aging. But in reality, there are reasons people are tired, and those reasons need to be investigated. For clinicians, the message from our study is that a lack of energy is widespread in the elderly, but it's not normal."
In the study, the researchers from the Stroud Center for the Studies of Quality of Life at Columbia University Medical Center surveyed over 2100 residents of New York City between ages 65 and 104. Residents rated their own health and answered seven questions related to energy level. Participants were labeled "anergic" if they said they "sit around a lot for lack of energy," and agreed with any two of the six following statements:
- I recently have had not enough energy.
- I felt slowed physically in past month.
- I did less than usual in past month.
- My slowness is worse in the morning.
- I wake up feeling tired.
- I nap over two hours during the day.
Eighteen percent of the study's participants met the criteria for anergia, by agreeing with two of the statements.
Anergia may stem from many conditions, including heart and kidney dysfunction, arthritis, lung disease, anemia and depression, or it may have additional yet presently unexplained origins.
The authors delineated factors that were independently associated with the presence of anergia (lack of energy), including reduced physical function, depression, pain, respiratory symptoms, urinary incontinence, hearing difficulty, feeling dizzy or weak, social isolation and social disengagement. Each of these is suggested as causal or contributing factors that should be investigated initially and independently, and could become potential targets for future intervention.
Being tired was also a telltale sign of serious health problems. People classified as anergic reported more arthritis, sleep disorders, cardiovascular symptoms and other health issues. They also reported twice as many overnight hospitalizations and emergency department visits. Anergia was also associated with a 60 percent greater rate of death in the six years after the survey was conducted.
"I believe anergia is the universal language by which the elderly talk about their health problems," said Dr. Maurer. "Instead of noting symptoms of pain or a depressed mood, many older adults feel more comfortable telling their physicians that they are tired. As health care providers, we need to start learning how to further identify the underlying causes of this lack of vigor and address them."
"Unraveling the causes of anergia will expand the scope of geriatric interventions that enable aging persons to preserve their quality of life," said Barry J. Gurland, M.D., of the Columbia University Stroud Center for the Studies of Quality of Life, who was also an author of the study. More research is needed to determine if treating anergia can improve health outcomes.
Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States. Established in 1767, Columbia's College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. The mission of the Morris W. Stroud III Center for Studies of Quality of Life is to foster scholarly activities contributing to the prevention or delaying the losses in the qualities of living that may accompany chronic diseases or aging. Huai Cheng, M.D., assistant clinical professor of medicine, was the first author of this study.
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