Net Worth Predicts Symptom Burden at the End of Life

TitleNet Worth Predicts Symptom Burden at the End of Life
Publication TypeJournal Article
Year of Publication2005
AuthorsSilveira, MJ, Kabeto, MU, Langa, KM
JournalJournal of Palliative Medicine
Call Numberpubs_2005_Silviera.pdf
KeywordsHealth Conditions and Status, Net Worth and Assets

OBJECTIVES: To explore the predictors of symptom burden at the end of life. DESIGN: Observational, secondary analysis of Health and Retirement Study (HRS) data. SETTING: USA. PARTICIPANTS: 2,604 deceased, older adults. METHODS: Multivariate Poisson and logistic regression to explore the relationship between socio-demographic and clinical factors with symptoms. RESULTS: Fatigue, pain, dyspnea, depression, and anorexia were common and severe; 58 of participants experienced 3 of these during their last year of life. Socio-demographic and clinical factors were associated with the number of symptoms as well as the presence of pain, depression, and dyspnea alone. Decedents in the highest quartile of net worth had fewer symptoms (IRR 0.90, CI 0.85-0.96) and less pain (OR 0.66, CI 0.51-0.85) than comparisons did. Cancer patients experienced more pain (OR 2.02, CI 1.62-2.53) and depression (OR 1.31, CI 1.07-1.61). Dementia patients experienced more depression (OR 2.37, CI 1.85-3.03) and dyspnea (OR 1.40, CI 1.09-1.78). LIMITATION: Use of proxy reports for primary data. CONCLUSION: Older Americans experience a large symptom burden in the last year of life, largely with treatable symptoms such as pain, dyspnea, and depression. The adequacy of symptom control relates to clinical factors as well as net worth. This association between symptoms and wealth suggests that access to health care and other social services beyond those covered by Medicare may be important in decreasing symptom burden at the end of life.

Endnote Keywords

Quality of Life/Net Worth

Endnote ID


Citation Key7010