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J Am Geriatr Soc. 2014 Mar;62(3):476-81. doi: 10.1111/jgs.12685. Epub 2014 Feb 11.

Epidemiology of restricting fatigue in older adults: the precipitating events project.

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Section of Geriatrics, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut.



To estimate the rate of restricting fatigue in community-living older adults and to determine whether the rates differ according to age, sex, race, physical frailty, and depression.


Prospective cohort study.


Greater New Haven, Connecticut.


Nondisabled community-living older men and women aged 70 and older (N = 754).


Restricting fatigue was defined as staying in bed for at least half the day and/or cutting down on one's usual activities because of fatigue for 3 consecutive months or longer. Physical frailty was defined on the basis of slow gait speed, and depression was assessed using the Center for Epidemiologic Studies Depression Scale.


During a median follow-up of 111 months, the cumulative incidence of restricting fatigue was 31.1% for men and 42.1% for women. The overall incidence rate of restricting fatigue was 6.7 per 1,000 person-months (7.8 for women and 4.4 for men, P < .001), which did not differ according to race. Rates were higher in persons who were physically frail than those who were not (P < .001), in those who were depressed than those who were not (P < .001), and in persons aged 75 to 79 and 80 to 84 than those aged 70 to 74 (both P < .01) but not in those aged 85 and older. Of the 459 episodes of restricting fatigue, the median duration was 3 months, which did not differ according to age, sex, race, physical frailty, or depression.


Restricting fatigue is common in community-living older adults. Women, individuals aged 75 to 84, and individuals with physical frailty or depression had higher rates of restricting fatigue than their respective counterparts.


aging; cohort study; epidemiology; fatigue; restricted activity

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