Characterizing symptom burden among community-dwelling older adults

• Community-dwelling older adults often experience multiple co-occurring symptoms. • Four distinct symptom burden classes were identified among a population-based cohort of community-dwelling older adults with over 70 % experiencing moderate to severe symptom burden. • Increased symptom burden class is associated with increased age, decreased physical activity, and presence of comorbid disease. Older adults experience multiple co-occurring symptoms that contribute to increased healthcare utilization, decreased physical performance, and poorer quality of life. This study aimed to characterize symptom burden in a population-based cohort of community-dwelling adults aged 70 years and older enrolled in the MOBILIZE Boston study (n=765). Descriptive statistics and chi-square tests were used to categorize symptom prevalence and associations with demographic factors for nine symptoms: pain, balance impairment, weakness, limited endurance, sleep difficulty, depression, anxiety, and hearing and vision impairments. Latent class analysis was used to identify distinct classes of symptom burden. Pain was the most prevalent symptom (81.3 %), with 43.1 % of individuals indicating severe pain. Symptoms related to vision, hearing, sleep, and endurance were also reported by over 40 % of individuals. Except for vision, reported symptoms were found to be positively correlated. Four symptom burden groups were identified via latent class analysis: mild (30.1 %), moderate (51.3 %), moderate-severe (10.2 %) and severe (8.4 %). Those in the severe symptom burden group experienced worse levels of all symptoms compared to other groups. Pain and vision symptoms were similar across all symptom burden classes. Balance, endurance, weakness, anxiety and sleep symptoms were comparatively more common and severe for the 18.6 % of individuals in the moderate-severe and severe groups. Understanding overall symptom burden, both in terms of numbers and severity of symptoms, is the first step in determining the impact of symptom burden as a possible new clinical indicator for fall risk and other detrimental health outcomes.