Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis

V Knoop; B Cloots; A Costenoble; A Debain; R Vella Azzopardi; S Vermeiren; B Jansen; A Scafoglieri; I Bautmans; Gerontopole Brussels Study group

doi:10.1016/j.arr.2021.101261

Fatigue and the prediction of negative health outcomes: A systematic review with meta-analysis

Ageing Res Rev. 2021 May:67:101261. doi: 10.1016/j.arr.2021.101261. Epub 2021 Feb 3.

Authors

V Knoop¹, B Cloots¹, A Costenoble¹, A Debain², R Vella Azzopardi², S Vermeiren¹, B Jansen³, A Scafoglieri⁴, I Bautmans⁵; Gerontopole Brussels Study group

Collaborators

Gerontopole Brussels Study group:
Ivan Bautmans⁶, Dominque Verté⁷, Ingo Beyer⁸, Mirko Petrovic⁹, Liesbeth De Donder¹⁰, Tinie Kardol¹¹, Gina Rossi¹², Peter Clarys¹³, Aldo Scafoglieri¹⁴, Erik Cattrysse¹⁵, Paul de Hert¹⁶, Bart Jansen¹⁷

Affiliations

¹ Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium.
² Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
³ Department of Electronics and Informatics ETRO, Vrije Universiteit Brussel (VUB), Elsene, Belgium; Imec, Leuven, Belgium.
⁴ Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Supporting Clinical Science Department and Research Department of Experimental Anatomy (EXAN), Vrije Universiteit Brussel (VUB), Brussels, Belgium.
⁵ Gerontology Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research Department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium. Electronic address: ivan.bautmans@vub.be.
⁶ FRIA, VUB, Belgium. Electronic address: ivan.bautmans@vub.be.
⁷ Belgian Ageing Studies BAST, VUB, Belgium. Electronic address: dominique.verte@vub.be.
⁸ Geriatric Medicine Department, UZ Brussel, Belgium. Electronic address: ingo.beyer@uzbrussel.be.
⁹ ReFrail, UGent, Belgium. Electronic address: mirko.petrovic@ugent.be.
¹⁰ Belgian Ageing Studies BAST, VUB, Belgium. Electronic address: liesbeth.de.donder@vub.be.
¹¹ Leerstoel Bevordering Active Ageing, VUB, Belgium. Electronic address: mjmkardol@hotmail.com.
¹² Clinical and Lifespan Psychology KLEP, VUB, Belgium. Electronic address: grossi@vub.be.
¹³ Physical Activity and Nutrition PANU, VUB, Belgium. Electronic address: pclarys@vub.be.
¹⁴ Experimental Anatomy EXAN, VUB, Belgium. Electronic address: aldo.scafoglieri@vub.be.
¹⁵ Experimental Anatomy EXAN, VUB, Belgium. Electronic address: ecattrys@vub.be.
¹⁶ Fundamental Rights and Constitutionalism Research Group FRC, VUB, Belgium. Electronic address: paul.de.hert@vub.be.
¹⁷ Department of Electronics and Informatics ETRO, VUB, Belgium. Electronic address: bart.jansen@vub.be.

PMID: 33548508
DOI: 10.1016/j.arr.2021.101261

Abstract

Introduction: Fatigue is a common complaint among older adults. Evidence grows that fatigue is linked to several negative health outcomes. A general overview of fatigue and its relationship with negative health outcomes still lacks in the existing literature. This brings complications for healthcare professionals and researchers to identify fatigue-related health risks. Therefore, this study gives an overview of the prospective predictive value of the main negative health outcomes for fatigue in community-dwelling older adults.

Methods: PubMed, Web of Knowledge and PsycINFO were systematically screened for prospective studies regarding the relationship between fatigue and negative health outcomes resulting in 4595 articles (last search 5th March 2020). Meta-analyses were conducted in RevMan using Odds ratios (ORs), Hazard ratios (HRs) and relative risk ratios (RR) that were extracted from the included studies. Subgroup-analyses were performed based on (1) gender (male/female), (2) length of follow-up and (3) fatigue level (low, medium and high).

Results: In total, thirty articles were included for this systematic review and meta-analysis encompassing 152 711 participants (age range 40-98 years), providing information on the relationship between fatigue and health outcomes. The results showed that fatigue is related to an increased risk for the occurrence of all studied health outcomes (range OR 1.299-3.094; HR/RR 1.038-1.471); for example, mortality OR 2.14 [1.74-2.63]; HR/RR 1.44 [1.28-1.62]), the development of disabilities in basic activities of daily living (OR 3.22 [2.05-5.38]), or the occurrence of physical decline (OR 1.42 [1.29-1.57]).

Conclusion: Overall fatigue increases the risk for developing negative health outcomes. The analyses presented in this study show that fatigue related physical decline occurs earlier than hospitalization, diseases and mortality, suggesting the importance of early interventions.

Keywords: Community-Dwelling; Elderly; Fatigue; Meta-Analysis; Prospective risk outcomes; Tiredness.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Activities of Daily Living*
Aged
Aged, 80 and over
Fatigue* / epidemiology
Female
Humans
Independent Living
Male
Prospective Studies