Evidence map›Paper›PMID 33145752›Full record

ArticleJournal of the American Geriatrics Society2021

Trends in Restricting Symptoms at the End of Life from 1998 to 2019: A Cohort Study of Older Persons.

Thomas M Gill, Evelyne A Gahbauer, Linda Leo-Summers, Terrence E Murphy

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Thomas M GillDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-6450-0368
Evelyne A GahbauerDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Linda Leo-SummersDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
Terrence E MurphyDepartment of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-9649-517X

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Yale Study Support Suite (YES3): Dashboard and Web Portal Software Supporting Research Workflow through integrated, customizable REDCap External ModulesP30AG021342 · NIA · YALE UNIVERSITY · PI Denise Esserman · 2002 to 2026
$37.9M
VULNERABILITY, INTERVENING EVENTS &DISABILITY IN AGINGR01AG017560 · NIA · YALE UNIVERSITY · PI GILL, THOMAS MICHAEL · 2000 to 2025
$7.0M
NCATS NIH HHS UL1 TR001863NIA NIH HHS P30 AG021342NIA NIH HHS P30AG21342NIA NIH HHS R01 AG017560NIA NIH HHS R01AG17560
6 · The paper itself

Abstract

objectivesTo describe changes in the occurrence of restricting symptoms at the end of life from 1998 to 2019 and compare these changes according to the condition leading to death.

designProspective longitudinal study.

settingGreater New Haven, CT.

participantsA total of 665 decedents from a cohort of 754 community-living persons, 70 years or older. MEASUREMENTS: The occurrence of 16 restricting symptoms was ascertained during monthly interviews. Information on the conditions leading to death was obtained from death certificates and comprehensive assessments that were completed every 18-months. For each restricting symptom, adjusted rates (per 100 person-months) were calculated separately for six multiyear time intervals.

resultsFrom 1998 to 2019, rates decreased for five (31.3%) restricting symptoms (difficulty sleeping; chest pain or tightness; shortness of breath; cold or flu symptoms; and nausea, vomiting, or diarrhea), increased for three (18.8%: arm or leg weakness; urinary incontinence; and memory or thinking problem), and changed little for the other eight (50.0%: poor eyesight; anxiety; depression; musculoskeletal pain; fatigue; dizziness or unsteadiness; frequent or painful urination; and swelling in feet or ankles). The decrease in rates was most pronounced for shortness of breath, with a reduction from 15.0 (95% credible interval = 11.7-18.6) in 1998 to 2001 to 8.2 (95% credible interval = 5.9-10.5) in 2014 to 2019, yielding a rate ratio (95% credible interval) of 0.92 (0.86-0.98). When evaluated according to the condition leading to death, the results were similar, with 10 of the 13 statistically significant rate ratios representing decreases in rates over time and only 3 representing increases.

conclusionThe occurrence of most restricting symptoms at the end of life has been decreasing or stable over the past two decades. These results suggest that end-of-life care has been improving, although additional efforts will be needed to further reduce symptom burden at the end of life.

Indexed as

Cause of DeathDeathMultiple Organ FailureSymptom AssessmentTerminal CareAgedAged, 80 and overCohort StudiesDeath CertificatesFemaleHumansIndependent LivingLongitudinal StudiesMalePalliative CarePatient Comfortlongitudinal studyolder personspalliative caresymptoms

Identifiers

PMID33145752
PMCPMC8186950

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.