University of Oulu

Tuuli E Lehti and others, Changes in symptom burden from 2019 to 2021 amongst community-dwelling older adults in Finland, Age and Ageing, Volume 52, Issue 1, January 2023, afac317,

Changes in symptom burden from 2019 to 2021 amongst community-dwelling older adults in Finland

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Author: Lehti, Tuuli E.1,2,3; Knuutila, Mia1,2,3; Öhman, Hanna4;
Organizations: 1Primary Health Care Unit, Helsinki University Hospital, Helsinki, Finland
2Social Services and Health Care, City of Helsinki, Helsinki, Finland
3Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
4Geriatric Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Geriatric Unit, Department of Internal Medicine, University of Helsinki, Helsinki, Finland
6Center for Life Course Health Research, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Oxford University Press, 2023
Publish Date: 2023-08-10


Background: Symptom burden causes suffering amongst older adults and is associated with healthcare visits and prognosis.

Aims: We evaluated the prevalence of 10 symptoms and changes in symptom burden amongst home-dwelling older adults in 2019 and 2021 using Finnish cohort data. We analysed factors associated with symptom burden increase during follow-up.

Methods: Altogether 1,637 people aged 75+ participated in the Helsinki Ageing Study postal survey in 2019, where they reported the presence of 10 common symptoms over the past 2 weeks. Of them, 785 participated in a follow-up in 2021, where the same symptoms were queried. We compared the prevalence of various symptoms and symptom burden scores in the 2-year interval and evaluated factors associated with increased symptom burden during this time.

Results: Of participants, 33% reported at least one daily symptom in 2019 versus 44% in 2021. Symptom burden increased by a mean ratio of 1.29 between 2019 and 2021. The most common symptoms were joint pain, back pain, urinary incontinence and fatigue. The prevalence of four symptoms increased between 2019 and 2021: joint pain, urinary incontinence, dizziness and shortness of breath. Higher age, reduced functional capacity and comorbidities were associated with higher odds of symptom burden increase during follow-up. Psychological well-being (PWB) was strongly associated with lower odds of symptom burden increase in the logistic regression model.

Conclusions: Symptom burden increased in our cohort aged 75+ between 2019 and 2021 before and during the COVID-19 pandemic. PWB was associated with lower odds of acquiring additional symptoms over time.

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Series: Age and ageing
ISSN: 0002-0729
ISSN-E: 1468-2834
ISSN-L: 0002-0729
Volume: 52
Issue: 1
Article number: afac317
DOI: 10.1093/ageing/afac317
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Päivikki and Sakari Sohlberg Foundation (to T.E.L.), the Kunnanlääkäri Uulo Arhio Fund (to T.E.L.), The Finnish Foundation for General Practice (to T.E.L.) and Helsinki University Hospital VTR funding.
Dataset Reference: Data are available on reasonable request.
Copyright information: © The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact