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Self-Reported Lack of Energy (Anergia) Among Elders in a Multiethnic Community

¹ Stroud Center for Studies of Quality of Life, ² Division of Geriatric Medicine and Aging, and the ³ Division of Cardiology, Section on Geriatric Cardiology, Columbia University, New York.

Address correspondence to Mathew S. Maurer, MD, Clinical Cardiovascular Research Laboratory for the Elderly, Columbia University Medical Center, 5141 Broadway, 3 Field West- Room 018, New York, NY 10034. E-mail: msm10{at}columbia.edu

Background. Lack of energy, "anergia," is a possible central feature for identifying, evaluating, and treating elders with health-related problems in quality of life.

Methods. A survey was conducted on a randomly selected stratified sample (N = 2130) of three ethnic groups of community-residing elders in a defined urban geographic area: the Northern Manhattan Aging Project (NMAP). The participants were Medicare beneficiaries living north of 150^th Street in Manhattan. The criteria for anergia were based on the presence of the major criterion "sits around a lot for lack of energy" and any two of six minor criteria. Self-reports were gathered using a computer-assisted, rater-administered interview (the Comprehensive Assessment and Referral Interview; CARE) covering: function (basic activities of daily living [ADL] and instrumental ADL [IADL]); features of geriatric syndromes such as self-rated physical health, depression, pain, respiratory distress, trouble sleeping, cognitive impairment, and cardiovascular syndromes; social isolation; and healthcare utilization. Short-term (18-month) and long-term (6-year) mortality were derived from the National Death Index.

Results. Three hundred eighty-six people (18% of the sample) met criteria for anergia. Anergia was more common in women than men (22% vs 12%, p <.01), in unmarried than in married persons (21% vs 13%, p <.001), and with advancing age. People with anergia used more hospitalizations, office visits, emergency room visits, and home care services and, had higher mortality rates. In multivariate analyses, the following factors had independent associations with anergia: female gender, impaired physical function and IADL, depression, pain, respiratory symptoms, urinary incontinence, hearing difficulty, feeling dizzy or weak, and social isolation and disengagement. These factors could be the initial candidates for clinical investigation of anergia of undetermined origin. Among people with anergia at baseline, 31.3% (n = 121) had persistent anergia and 33.9% (n = 131) recovered over a follow-up period of 18 months.

Conclusions. Anergia in multiethnic older adults is associated with a range of clinical symptoms and diseases, with extensive health services use, and with increased mortality.

Key Words: Anergia • Energy • Multiethnic • Elders