Factors associated with the persistence of medically unexplained symptoms in later life

Abstract

Both the older patient and the health professionals involved, and most particularly the therapist, experience problems with the assessment of the nature and the treatment of the impact of physical symptoms for which no medical diagnosis has been found. As a result, many of these older patients remain deprived of an adequate diagnosis and fitting, evidence-based treatment. The results of the studies collected in this thesis have added to our knowledge on the various factors associated with the persistence of medically unexplained symptoms (MUS) in older patients, while offering tools to explore and quantify relevant factors (e.g. the Illness Cognition Questionnaire-plus, ICQ-plus). Besides the many similarities between older and younger patients struggling with MUS and those between patients presenting with either MUS or medically explained symptoms (MES) (or both), there are also meaningful differences. When, during the assessment and treatment of MUS in later life, attention is paid to specific age-related problems, there are no reasons to exclude older patients from treatment or research. To improve the clinical assessment and management of later-life MUS, therapist training and research need to be stepped up because the growing number of older adults with physical symptoms, be they explained or not, deserve our attention to help them improve their (daily) functioning and regain their quality of life.