Symptom Clusters in Older Adults with Osteoarthritis

Saturday, 16 November 2013: 3:15 PM

Jeanne B Jenkins, PhD, RN, MBA
Thomas P McCoy, MS
School of Nursing, The University of North Carolina at Greensboro, Greensboro, NC

Learning Objective 1: The learner will be able to identify the symptom clusters in older adults with osteoarthritis of the knee

Learning Objective 2: The learner will be able to identify the effects of symptom clusters on the quality of life of older adults with osteoarthritis of the knee.

Background: One in two people may develop symptomatic knee osteoarthritis (OA) in their lifetime. Many OA sufferers have multiple concurrent symptoms, such as pain, fatigue, and depression. Research to date has focused primarily on single symptoms of OA, such as pain or functional status, but this approach is limited in its utility for guiding practice with older adults who present with multiple symptoms. Examining if symptom clusters exist among older adults with OA of the knee and their effects on patient outcomes, such as functional status and quality of life (QOL), is essential to provide evidence-based geriatric healthcare.

Aim: The purposes of this secondary analysis were to explore the existence of symptoms that form a cluster or clusters in older adults with OA of the knee, and to explore the effect of symptom clusters on functional status and QOL.

Method: A cross-sectional, methodological exploration of existing data from a convenience sample (N=75) of adults ages 50 and older was used. Hierarchical and k-means cluster analysis was performed to identify symptom clusters.  MANOVA was performed to test for any differences in QOL and functional status jointly. 


Results: Two large clusters of pain, fatigue, and depression were identified from cluster analysis.  Significant mean differences between symptom clusters existed on both functional status (p<0.0001) and QOL (p=0.0082). 


Conclusion: The findings of this study provide a foundation for future research evaluating symptom clusters and determining whether the clusters vary over time or along disease/treatment trajectory. Nurses need to be aware of the presence of symptom clusters and their possible synergistic adverse effect on the older adults’ QOL. Linking the symptom cluster to outcomes provides a basis for targeted nursing interventions aimed at improving the functional status and QOL of older adults with OA.