Physical symptoms as a predictor of health care use and mortality among older adults

Michael C. Sha, Christopher M. Callahan, Steven R. Counsell, Glenda R. Westmoreland, Timothy E. Stump, Kurt Kroenke

Research output: Contribution to journalArticle

70 Scopus citations


PURPOSE: To describe the patterns of physical symptoms in older adults and to examine the validity of symptoms in predicting hospitalization and mortality. SUBJECTS AND METHODS: Adults aged 60 years and older (N=3498) who completed screening for self-reported symptoms at routine primary care visits. Self-reported symptoms were collected using an abbreviated PRIME-MD screening instrument. Clinical characteristics, hospitalization, and mortality in the year following screening were measured using data taken from a comprehensive electronic medical record. RESULTS: The mean patient age was 69 years, 69% were women, and 56% were African-American. A majority (51%) of respondents characterized their health as fair or poor. The most commonly reported symptoms were musculoskeletal pain (65%), fatigue (55%), back pain (45%), shortness of breath (41%), and difficulty sleeping (38%). A summary score of physical symptoms (range 0-12) was a significant independent predictor of future hospitalization and death even when controlling for clinical characteristics, chronic medical conditions, self-rated health, and affective symptoms. Disease-specific symptoms were more common among patients diagnosed with the specific condition but there was also a substantial background prevalence of these symptoms. CONCLUSION: Physical symptoms are highly prevalent in older primary care patients and predict hospitalization and mortality at one year. Future work is needed to determine how to target symptoms as a potential mechanism to reduce health care use and mortality.

Original languageEnglish (US)
Pages (from-to)301-306
Number of pages6
JournalAmerican Journal of Medicine
Issue number3
StatePublished - Mar 2005


  • Health care use
  • Older adult
  • Symptoms

ASJC Scopus subject areas

  • Nursing(all)

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