Symptom clusters in hospitalized older adults: Characteristics and outcomes

Geriatr Nurs. 2021 Jan-Feb;42(1):240-246. doi: 10.1016/j.gerinurse.2020.08.007. Epub 2020 Sep 3.


Hospital care in medical patients relies mostly on objective measures with limited assessment of subjective symptoms. We subgrouped 331 hospitalized older adults with medical diagnosis (age 75.5 ± 7.1) according to the severity of multiple symptoms to explore if these subgroups differed in health-related characteristics on admission and functional outcomes one month post-discharge. Cluster analysis identified three subgroups based on experiences with five highly distressing symptoms (fatigue, dyspnea, dizziness, sleep disturbance, pain): low levels of all symptoms, high levels of all symptoms; moderate levels of four symptoms with high dyspnea. Belonging in different subgroups was accompanied by different levels of cognitive and mental, but not physical or health status. Patients in the subgroup "Moderate Levels with High Dyspnea" had significantly lower risk of decline in post-discharge instrumental activities of daily living than other subgroups. Better understanding of older hospitalized adults' symptom profiles may yield important information on health condition and recovery.

Keywords: Function; Hospital care; Nursing; Older adults; Patient outcomes; Quantitative methodology; Symptom management.

MeSH terms

  • Activities of Daily Living*
  • Aftercare*
  • Aged
  • Aged, 80 and over
  • Fatigue / epidemiology
  • Geriatric Nursing
  • Humans
  • Patient Discharge
  • Syndrome