Restricting Symptoms at the End of Life Decreasing

FRIDAY, Nov. 6, 2020 -- The occurrence of most restricting symptoms at the end of life has been decreasing during the last 20 years, according to a study published online Nov. 3 in the Journal of the American Geriatrics Society.

Thomas M. Gill, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues identified the occurrence of 16 restricting symptoms at the end of life from 1998 to 2019 and evaluated any changes according to the condition leading to death among 665 decedents from a cohort of 754 community-living persons ages 70 years and older.

The researchers found that rates decreased for five restricting symptoms (difficulty sleeping; chest pain or tightness; shortness of breath; cold or flu symptoms; and nausea, vomiting, or diarrhea), increased for three symptoms (arm or leg weakness; urinary incontinence; and memory or thinking problems), and changed little for eight symptoms (poor eyesight; anxiety; depression; musculoskeletal pain; fatigue; dizziness or unsteadiness; frequent or painful urination; and swelling in feet or ankles). The most pronounced decreases were seen for rates of shortness of breath (15.0 in 1998 to 2001 and 8.2 in 2014 to 2019), yielding a rate ratio of 0.92. Results were similar when evaluated by the condition leading to death, with 10 of the 13 statistically significant rate ratios representing decreases in rates over time and only three representing increases.

"These results suggest that end-of-life care has been improving, although additional efforts will be needed to further reduce symptom burden at the end of life," the authors write.

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Posted: November 2020