Brief Article
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World J Gastroenterol. Jul 7, 2011; 17(25): 3020-3026
Published online Jul 7, 2011. doi: 10.3748/wjg.v17.i25.3020
Association of upper gastrointestinal symptoms with functional and clinical characteristics in the elderly
Alberto Pilotto, Stefania Maggi, Marianna Noale, Marilisa Franceschi, Giancarlo Parisi, Gaetano Crepaldi
Alberto Pilotto, Geriatrics Unit, Azienda ULSS 16 Padova, S. Antonio Hospital, Padova, I-35127, Italy
Stefania Maggi, Marianna Noale, Gaetano Crepaldi, IPOD Investigators, Aging Section, National Research Council, Institute of Neuroscience, Padova, 35131, Italy
Marilisa Franceschi, Endoscopy Unit, Department of Surgery, ULSS4 Alto Vicentino, Schio (VI), 36015, Italy
Giancarlo Parisi, Department of Internal Medicine, General Hospital, Feltre (BL), 31100, Italy
Author contributions: Pilotto A, Maggi S and Franceschi M contributed to the study concept and design, interpretation of data, data analysis and preparation of manuscript; Noale M contributed to the study concept and design, interpretation of data and statistical analysis; Parisi G and Crepaldi G contributed to the study concept and design; all authors participated in discussing the results and critical revision of the manuscript; the IPOD Investigators selected patients and collected data.
Correspondence to: Alberto Pilotto, MD, Geriatrics Unit, Azienda ULSS 16 Padova, S. Antonio Hospital, Via Facciolati 71, Padova, I-35127, Italy. alberto.pilotto@sanita.padova.it
Telephone: +39-49-8215300 Fax: +39-49-8215302
Received: November 17, 2010
Revised: December 21, 2010
Accepted: December 28, 2010
Published online: July 7, 2011
Abstract

AIM: To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients.

METHODS: The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and demographic characteristics, function in the activities of daily living (ADL), co-morbidities and drug use were collected by a structured interview. Upper gastrointestinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters: (1) abdominal pain syndrome; (2) reflux syndrome; (3) indigestion syndrome; (4) bleeding; and (5) non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model.

RESULTS: 3100 subjects were included in the final analysis. The overall prevalence of upper gastrointestinal symptoms was 43.0%, i.e. cluster (1) 13.9%, (2) 21.9%, (3) 30.2%, (4) 1.2%, and (5) 4.5%. Upper gastrointestinal symptoms were more frequently reported by females (P < 0.0001), with high number of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001) and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex (OR = 1.39, 95% CI: 1.17-1.64), disability in the ADL (OR = 1.47, 95% CI: 1.12-1.93), smoking habit (OR = 1.29, 95% CI: 1.00-1.65), and body mass index (OR = 1.06, 95% CI: 1.04-1.08), as well as the presence of upper (OR = 3.01, 95% CI: 2.52-3.60) and lower gastroenterological diseases (OR = 2.25, 95%CI: 1.70-2.97), psychiatric (OR = 1.60, 95% CI: 1.28-2.01) and respiratory diseases (OR = 1.25, 95% CI: 1.01-1.54) were significantly associated with the presence of upper gastrointestinal symptoms.

CONCLUSION: Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimensional comprehensive evaluation may be useful when approaching upper gastrointestinal symptoms in older subjects.

Keywords: Upper gastrointestinal symptoms; Elderly; Upper gastro-intestinal symptom questionnaire for the elderly; Gastroesophageal reflux disease; Disability