University of Groningen, University Medical Center Groningen, Interdisciplinary Center for Psychopathology of Emotion regulation (ICPE), Groningen, the Netherlands; Mental Health Center Westelijk-Noord Brabant, Halsteren, the Netherlands.
Department of Geriatric Medicine/Radboudumc Alzheimer Center, Donders Institute for Medical Neurosciences, Radboud University Medical Center, Nijmegen, the Netherlands.
J Am Med Dir Assoc. 2019 Sep;20(9):1150-1155. doi: 10.1016/j.jamda.2019.02.015. Epub 2019 Apr 4.
To examine the level of frailty and somatic comorbidity in older patients with medically unexplained symptoms (MUS) and compare this to patients with medically explained symptoms (MES).
Cross-sectional, comparative study.
Community, primary care, and secondary healthcare to recruit patients with MUS in various developmental and severity stages and primary care to recruit patients with MES.
In total, 118 patients with MUS and 154 patients with MES, all aged ≥60 years.
Frailty was assessed according to the Fried criteria (gait speed, handgrip strength, unintentional weight loss, exhaustion, and low physical activity), somatic comorbidity according to the self-report Charlson comorbidity index, and the number of prescribed medications.
Although patients with MUS had less physical comorbidity compared with patients with MES, they were prescribed the same number of medications. Moreover, patients with MUS were more often frail compared with patients with MES. Among patients with MUS, physical frailty was associated with the severity of unexplained symptoms, the level of hypochondriacal beliefs, and the level of somatisation.
Despite a lower prevalence of overt somatic diseases, patients with MUS are more frail compared with older patients with MES. These results suggest that at least in some patients age-related phenomena might be erroneously classified as MUS, which may affect treatment strategy.
检查有医学无法解释症状（MUS）的老年患者的虚弱程度和躯体共病情况，并将其与有医学可解释症状（MES）的患者进行比较。
横断面、比较研究。
社区、初级保健和二级保健，招募处于不同发展和严重程度阶段的 MUS 患者，以及初级保健招募 MES 患者。
共有 118 名 MUS 患者和 154 名 MES 患者，年龄均≥60 岁。
根据 Fried 标准（步态速度、握力、非故意体重减轻、疲惫和低体力活动）评估虚弱程度，根据自我报告的 Charlson 共病指数评估躯体共病，以及开处的药物数量。
尽管与 MES 患者相比，MUS 患者的身体共病较少，但他们开的药物数量相同。此外，与 MES 患者相比，MUS 患者更虚弱。在 MUS 患者中，身体虚弱与无法解释症状的严重程度、疑病症信念水平和躯体化水平有关。
尽管明显的躯体疾病患病率较低，但与 MES 老年患者相比，MUS 患者更虚弱。这些结果表明，至少在某些患者中，与年龄相关的现象可能被错误地归类为 MUS，这可能会影响治疗策略。
