Lack of Energy Might Not Be "Just a Part of Growing Old"

Feeling tired may be a sign of a treatable condition.

"Old and tired" is such a common phrase that it's no surprise that, according to a study in the Journal of Gerontology, almost one in five senior citizens report having so little energy that they spend most of the day sitting on the couch.

But even though a lack of energy is common in the elderly, the study's authors say that physicians should take their patients' reports more seriously, because a lack of energy—a condition called anergia—is linked to several health problems and greater rates of hospitalization and death. The authors state that anergia constitutes a geriatric syndrome similar to other common syndromes associated with ageing, such as falling and memory impairments. 

"When elderly patients complain they're tired, most doctors say, yeah, well, you're old," reports Mathew Maurer, MD, associate professor of Clinical Medicine at Columbia University Medical Center. "They tell their patients that feeling listless is an expected part of ageing. But in reality, there are reasons people are tired, and those reasons need to be investigated. A lack of energy is widespread in the elderly, but it's not normal."

In the study, the researchers surveyed over 2100 seniors from ages 65 to 104, who rated their own health and answered seven questions related to energy level. Participants were labeled "anergic" if they said they "sit around a lot for lack of energy," and agreed with any two of the six following statements:

1. I recently have not had enough energy.
2. I felt slowed physically in past month.
3. I did less than usual in past month.
4. My slowness is worse in the morning.
5. I wake up feeling tired.
6. I nap over two hours during the day.

Eighteen percent of the study's participants met the criteria for anergia.

Anergia may stem from many conditions, including heart and kidney dysfunction, arthritis, lung disease, anemia and depression, or it may have additional yet presently unexplained origins.

The authors named factors that were independently associated with the presence of anergia, including reduced physical function, depression, pain, respiratory symptoms, urinary incontinence, hearing difficulty, feeling dizzy or weak, social isolation and social disengagement. These factors should be investigated, and could become potential targets for future intervention.

Being tired was also a telltale sign of serious health problems. People classified as anergic reported more arthritis, sleep disorders, cardiovascular symptoms and other health issues. They also reported twice as many overnight hospitalizations and emergency department visits. Anergia was associated with a 60% greater rate of death in the six years after the survey was conducted.

"I believe anergia is the universal language by which the elderly talk about their health problems," said Dr. Maurer. "Instead of noting symptoms of pain or a depressed mood, many older adults feel more comfortable telling their physicians that they are tired. As health care providers, we need to start learning how to further identify the underlying causes of this lack of vigor and address them."

Source: Columbia University Medical Center Morris W. Stroud III Center for Studies of Quality of Life.