Medically Unexplained Symptoms in Later Life: Preliminary findings of Patient Characteristics and Quality of Life

Abstract

Introduction: When physical symptoms last for more than three months and, even after adequate physical screening, no sufficient somatic explanation can be found, we refer to those complaints as Medically Unexplained Symptoms (MUS). MUS are common in older patients, with prevalence estimates between 4.6% and 18%. Although many studies have focused on MUS in adulthood, studies in elderly patients are scarce, because it can be challenging to differentiate between explained and unexplained physical symptoms at later life. The OPUS (Older Patients with medically Unexplained Symptoms) study aims to provide insight into patient characteristics of older patients with MUS. In line with the biopsychosocial model, our principal research question is: To what extent predict physical, psychological and social determinants MUS in older patients? Preliminary findings regarding to Quality of Life (QoL), perceived health and health anxiety will be presented. Methods: The OPUS Study is a case control study, in which older patients (>60 years) with MUS are compared to older patients with explained physical symptoms. Results of an interim analysis, consisting of the first 111 subjects, are shown. 47 MUS patients and 64 control patients were selected by their general practitioners (N=63), a multidisciplinary clinic for patients with MUS (N=18), the Geriatric Department of our University Hospital (N=8) or they referred their selves (N=22). A multidisciplinary panel of specialists (geriatrician, psychiatrist and psychologist) checked on all participants with MUS to ensure that there really was no sufficient explanation for their physical symptoms. Afterwards, a researcher visited the participants at home for additional measurements. Patients with explained physical symptoms only had two home visits. Physical, psychological and social characteristics were measured using validated questionnaires. For this preliminary analysis three measures were used, a score from one (low QoL) to ten (high QoL) in response to the question 'How would you grade your life at this moment?' for measuring QoL, a score on a five-point Likert item in response to the question 'How is your health in general?' with higher scores indicating poor perceived health, and the sum score on the Whitely Index, a 14-item self-report measuring health anxiety (range 0 -14, with higher scores indicating increased health anxiety). Results: There was a significant difference of perceived health in patients with MUS compared to patients with explained physical symptoms after controlling for age (F(1,2)=8.47, p