A new study in the Journal of the American Geriatrics Society shows that symptoms, either from illness or other causes, increase with age, and older adults with many symptoms have increased risk of falls, hospitalizations, disability, and mortality.

Researchers analyzed information from the National Health and Aging Trends study to determine the prevalence and impact of common symptoms among individuals age 65 and older. The study is ongoing and includes information from more than 7,600 Medicare beneficiaries for the years 2011 to 2017.

Symptoms assessed included pain, fatigue, breathing difficulty, sleeping difficulty, depressed mood, and anxiety. The researchers examined several outcomes, including grip strength, gait speed, and overall lower-extremity function, among others.

Three-fourths of participants reported at least one of the six symptoms, and almost half had two or more
symptoms. About 13.6 percent of participants had four or more symptoms, according to the study.

“For each symptom, there was a high co-occurrence with the other symptoms,” study researchers said. “The most prevalent co-­occurring symptoms were pain and fatigue, and the most common triad of symptoms included pain, fatigue, and sleep difficulty.”

Demographic and health characteristics varied according to symptom count at baseline of the study.

Generally, symptom count increased with advancing age, and women were likely to have more symptoms than men. Furthermore, older adults with lower levels of education had higher symptom counts than those with higher education.

“Older adults with more symptoms were weaker, slower, and had poorer lower-extremity performance than those with few symptoms,” the study said. The researchers also found that the risk of developing clinically significant muscle weakness, slow gait speed, and poor lower-extremity function over time increased significantly with a greater number of symptoms.

In addition to increased risk of poor physical performance over time, the incidence of recurrent falls, hospitalization, and disability in basic activities of daily living increased with a greater number of symptoms, the study said. Compared with older adults who did not report any symptoms, there was approximately a twofold higher risk of falls, hospitalization, and disability among those with four or more symptoms.

The risk of skilled nursing center admission was also higher among those with greater symptom counts and a graded relationship of symptom count with mortality.

“As the population ages and the prevalence of multiple chronic conditions increases, the number and proportion of older adults with multiple chronic symptoms is likely to grow,” the researchers said. “In light of the current study, further multidisciplinary research on symptoms is needed to ultimately develop effective symptom management interventions.”