Skip to main content
SpringerLink
Log in

Managing Fatigue

  • Chapter
  • First Online:
Nursing Older People with Arthritis and other Rheumatological Conditions

  • 566 Accesses

Abstract

This chapter will provide an overview of fatigue in older adults with arthritis, focusing on the causes, assessment and investigations used to identify fatigue. This chapter will also present the pharmacological and non-pharmacological interventions used to manage fatigue in older people with arthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ahn GE, Ramsey-Goldman R. Fatigue in systemic lupus erythematosus. Int J Clin Rheumatol. 2012;7(2):217–27.

    Article  Google Scholar 

  • Aissaoui N, Rostom S, Hakkou J, Ghziouel KB, Bahiri R, Abouqal R, Hassouni NH. Fatigue in patients with ankylosing spondylitis: prevalence and relationships with disease-specific variables, psychological status and sleep disturbance. Rheumatol Int. 2012;32:2117–24.

    Article  CAS  PubMed  Google Scholar 

  • Almeida C, Choy EH, Hewlett S, Kirwan JR, Cramp F, Chalder T, Pollock J, Christensen R. Biologic interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev. 2016;6(6):CD008334.

    Google Scholar 

  • Avlund K. Fatigue in older adults: an early indicator of the aging process? Aging Clin Exp Res. 2010;22(2):100–15.

    Article  PubMed  Google Scholar 

  • Barlow J, Turner A, Swaby L, Gilchrist M, Wright C, Doherty M. An 8-yr follow-up of arthritis self-management programme participants. Rheumatology. 2009;48(2):128–33.

    Article  CAS  PubMed  Google Scholar 

  • Belza BL. Comparison of self-reported fatigue in rheumatoid arthritis and controls. J Rheumatol. 1995;22(4):639–43.

    CAS  PubMed  Google Scholar 

  • Bianchi WA, Elias FR, Carneiro S, Bortoluzzo AB, Bertolo MB, Ribeiro SL, Keiserman M. Assessment of fatigue in large series of 1492 Brazilian patients with spondyloarthritis. Mod Rheumatol. 2014;24(6):980–4.

    Article  PubMed  Google Scholar 

  • Braun J, Brandt J, Listing J, Zink A, Alten R, Golder W, Gromnica-Ihle E, Kellner H, Schneider M, Sorensen H, Zeidler H, Thriene W, Sieper J. Treatment of ankylosing spondylitis with infliximab: a randomised controlled trial. Lancet. 2002;359:1187–93.

    Article  CAS  PubMed  Google Scholar 

  • Brophy S, Davies H, Dennis MS, Cooksey R, Hussain MJ, Irvine E, Sieber S. Fatigue in ankylosing spondylitis: treatment should focus on pain management. Semin Arthritis Rheum. 2013;42:361–7.

    Article  PubMed  Google Scholar 

  • Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL. Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev. 2007;17(4):CD003786.

    Google Scholar 

  • Chauffier K, Salliot C, Berenbaum F, Sellam J. Effect of biotherapies on fatigue in rheumatoid arthritis: a systematic review of the literature and meta-analysis. Rheumatology. 2012;51(1):60–8.

    Article  CAS  PubMed  Google Scholar 

  • Cramp F, Hewlett S, Almeida C, Kirwan JR, Choy EH, Chalder T, Pollock J, Christensen R. Non-pharmacological interventions for fatigue in rheumatoid arthritis. Cochrane Database Syst Rev. 2013;23(8):CD008322.

    Google Scholar 

  • Deodhar AA, Dougados M, Baeten DL, Wei JC, Geusens P, Readie A, Richards HB, Martin R, Porter B. Effect of secukinumab on patient reported outcomes in patients with active ankylosing spondylitis. Arthritis Rheumatol. 2016;68(12):2901–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Eilertsen G, Ormstad H, Kirkevold M, Mengshoel AM, Soderberg S, Olsson M. Similarities and differences in the experience of fatigue among people living with fibromyalgia, multiple sclerosis, ankylosing spondylitis and stroke. J Clin Nurs. 2015;24:2023–34.

    Article  PubMed  Google Scholar 

  • Eldahah BA. Fatigue and fatigability in older adults. PM R. 2010;2:406–13.

    Article  Google Scholar 

  • Fenn K, Byrne M. The key principles of cognitive behavioural therapy. InnovAiT. 2013;6(9):579–85.

    Article  Google Scholar 

  • Gracely RH, Ceko M, Bushnell MC. Fibromyalgia and depression. Pain Res Treat. 2012;2012:486590. https://doi.org/10.1155/2012/486590.

    Article  PubMed  Google Scholar 

  • Greco CM, Rudy TE, Manzi S. Effects of a stress-reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: a randomized controlled trial. Arthritis Rheum. 2004;51(4):625–34.

    Article  PubMed  Google Scholar 

  • Gunaydin R, Karatepe AG, Cesmeli N, Kaya T. Fatigue in patients with ankylosing spoondylitis: relationships with disease-specific variables, depression and sleep disturbance. Clin Rheumatol. 2009;28:1045–51.

    Article  PubMed  Google Scholar 

  • Hammond A, Freeman K. Community patient education and exercise for people with fibromyalgia: a parallel group randomized controlled trial. Clin Rehabil. 2006;20(10):835–46.

    Article  PubMed  Google Scholar 

  • Hardy SE, Studenski SA. Qualities of fatigue and associated chronic conditions among older adults. J Pain Symptom Manag. 2010;39(6):1033–42.

    Article  Google Scholar 

  • Haywood KL, Packham JC, Jordan KP. Assessing fatigue in ankylosing spondylitis: the importance of frequency and severity. Rheumatology. 2014;53(3):552–6.

    Article  PubMed  Google Scholar 

  • Hewlett S, Nicklin J, Treharne GJ. Fatigue in musculoskeletal conditions. Topical reviews: Reports on the rheumatic diseases series 6. 2008. http://eprints.uwe.ac.uk/10682/1/ARC_topic_Review_Fatigue08.pdf.

  • Hewlett S, Dures E, Almeida C. Measures of fatigue. Arthritis Care Res. 2011;63(S11):S263–86.

    Article  Google Scholar 

  • Jason LA, Evans M, Brown M, Porter N. What is fatigue? Pathological and nonpathological fatigue. PM R. 2010;2:327–31.

    Article  PubMed  Google Scholar 

  • Karlson EW, Liang MH, Eaton H, Huang J, Fitzgerald L, Rogers MP, Daltroy LH. A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus. Arthritis Rheum. 2004;50(6):1832–41.

    Article  PubMed  Google Scholar 

  • Katz P, Margaretten M, Trupin L, Schmajuk G, Yazdany J, Yelin E. Role of sleep disturbance, depression, obesity and physical inactivity in fatigue in rheumatoid arthritis. Arthritis Care Res. 2016;61:81–90.

    Article  Google Scholar 

  • Kroenke K, Spitzer R. Gender differences in the reporting of physical and somatoform symptoms. Psychosom Med. 1998;60(2):150–5.

    Article  CAS  PubMed  Google Scholar 

  • Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.

    Article  CAS  PubMed  Google Scholar 

  • Lopez-Medina C, Schiotis RE, Ugalde PF, Castro-Villegas MC, Calvo-Gutierres J, Ortega-Castro R, Jimenez-Gasco R, Escudero-Contreras JC, Collantes-Estevez E. Assessment of fatigue in spondyloarthritis and its association with disease activity. J Rheumatol. 2016;43(4):751–7.

    Article  PubMed  Google Scholar 

  • Matcham F, Ali S, Hotopf M, Chalder T. Psychological correlates of fatigue in rheumatoid arthritis: a systematic review. Clin Psychol Rev. 2015;39(1):6–29.

    Google Scholar 

  • Missaoui B, Revel M. Fatigue in ankylosing spondylitis. Ann Phys Rehabil Med. 2006;49:389–91.

    Google Scholar 

  • Moldovan I, Cooray D, Carr F, Katsaros E, Torralba K, Shinada S, Ishimori M, Jolly M, Wilson A, Wallace D, Weisman M, Nicassio P. Pain and depression predict self-reported fatigue/energy in lupus. Lupus. 2013;22(7):684–9.

    Article  CAS  PubMed  Google Scholar 

  • Murphy SL, Smith DM. Ecological measurement of fatigue and fatigability in older adults with osteoarthritis. J Gerontol A Biol Sci Med Sci. 2010;65A(2):184–9.

    Article  Google Scholar 

  • Nicassio PM, Moxham EG, Gervitz RN. The contribution of pain, reported sleep quality and depressive symptoms to fatigue in fibromyalgia. Pain. 2002;100(3):271–9.

    Article  PubMed  Google Scholar 

  • Nicholaus S, Bode C, Taal E, Van der Laar M. Fatigue and factors related to fatigue in rheumatoid arthritis: a systemic review. Arthritis Care Res (Hoboken). 2013;65:1128–246.

    Article  Google Scholar 

  • Nicklin J, Cramp F, Kirwan J, Urban M, Hewlett S. Collaboration with patients in the design of patient-reported outcome measures: capturing the experience of fatigue in rheumatoid arthritis. Arthritis Rheum. 2010;62(11):1552–8.

    Article  Google Scholar 

  • Niedermann K, Sidelnikov E, Muggli C, Dagfinrud H, Hermann M, Tamborrini G, Ciurea A, Bischoff-Ferrari H. Effect of cardiovascular training on fitness and perceived disease activity in people with ankylosing spondylitis. Arthritis Care Res. 2013;65(11):1844–52.

    Article  Google Scholar 

  • O’Connell C, Stokes E. Fatigue. In: Kauffman TL, Scott WR, Barr JO, Moran ML, editors. A comprehensive guide to geriatric rehabilitation. 3rd ed. London: Churchill Livingstone/Elsevier; 2014. p. 453–5.

    Chapter  Google Scholar 

  • O’Malley PG, Balden E, Tomkins G, Santoro J, Kroenke K, Jackson JL. Treatment of fibromyalgia with antidepressants: a meta-analysis. J Gen Intern Med. 2000;15(9):659–66.

    Article  PubMed  PubMed Central  Google Scholar 

  • Overman CL, Kool MB, Da Silva JAP, Geenen R. The prevalence of severe fatigue in rheumatic diseases: an international study. Clin Rheumatol. 2016;35:409–15.

    Article  PubMed  Google Scholar 

  • Philips EM, Schneider JC, Mercer GR. Motivating elders to initiate and maintain exercise. Arch Phys Med Rehabil. 2004;85(3):S52–7.

    Article  Google Scholar 

  • Piper B. Pathophysiological phenomena in nursing: human responses to illness. USA: W.B. Saunders; 1993.

    Google Scholar 

  • Power JD, Badley EM, French MR, Wall AJ, Hawker GA. Fatigue in osteoarthritis: a qualitative study. BMC Musculoskelet Disord. 2008;9:63. http://www.biomedcentral.com/1471-2474/9/63.

    Article  PubMed  PubMed Central  Google Scholar 

  • Repping-Wuts H, Van Riel P, Van Achterberg T. Fatigue in patients with rheumatoid arthritis: what is known and what is needed. Rheumatology. 2009;48(3):207–9.

    Article  CAS  PubMed  Google Scholar 

  • Reygaertts T, Fautrel B, Mitrovic S, Gossec L. Effect of biologics on fatigue in psoriatic arthritis: a systematic literature review with meta-analysis. Joint Bone Spine. 2018;85(4):405–10.

    Article  Google Scholar 

  • Schakel W, Bode C, Van der Aa H, Hulshof C, Bosmans JE, Van Rens G, Van Nispen R. Exploring the patient perspective of fatigue in adults with visual impairment: a qualitative study. Br Med J Open. 2017;7(8):e015023. https://doi.org/10.1136/bmjopen-2016-015023.

    Article  Google Scholar 

  • Schneeberger EE, Marengo MF, Dal Pra F, Cocco JA, Citera G. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis. Clin Rheumatol. 2015;34:497–501.

    Article  PubMed  Google Scholar 

  • Sieper J, Kivitz A, Van Tubergen A, Deodhar A, Coteur G, Woltering F, Landewe R. Impact of certolizumab pegol on patient reported outcomes in patients with axial spondyloarthritis. Arthritis Care Res. 2015;67(10):1475–80.

    Article  CAS  Google Scholar 

  • Smets EM, Garssen B, Bonke B, De H. The multidimensional fatigue inventory (MFI) psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995;22:315–25.

    Article  Google Scholar 

  • Stebbings SM, Treharne GJ. Fatigue in rheumatic disease: an overview. Int J Clin Rheumatol. 2010;5(4):487–502.

    Article  Google Scholar 

  • Stebbings SM, Treharne GJ, Jenks K, Highton J. Fatigue in patients with spondyloarthritis associates with disease activity, quality of life and inflammatory bowel symptoms. Clin Rheumatol. 2014;33:1467–74.

    Article  PubMed  Google Scholar 

  • Targum SD, Fava M. Fatigue as a residual symptom of depression. Innov Clin Neurosci. 2011;8(10):40–3.

    PubMed  PubMed Central  Google Scholar 

  • Tench CM, McCarthy J, McCurdie I, White PD, D’Cruz DP. Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Rheumatology. 2003;42(9):1050–4.

    Article  CAS  PubMed  Google Scholar 

  • Tennant KF. Assessment of fatigue in older adults: the FACIT fatigue scale (version 4). 2012. https://www.hartfordign.org.

  • Turan Y, Duruoz MT, Bal S, Guvenc A, Cerrahoglu L, Gurgan A. Assessment of fatigue in patients with ankylosing spondylitis. Rheumatol Int. 2007;27:847–52.

    Article  PubMed  Google Scholar 

  • Uhlig T, Provan SA. Treating fatigue in rheumatoid arthritis: does age matter? Drugs Aging. 2018;35:871–6.

    Article  PubMed  Google Scholar 

  • Van Tubergen A, Coenen J, Landewe R, Spoorenberg A, Chorus A, Boonen A, Van Der Linden S, Van Der Hejde D. Assessment of fatigue in patients with ankylosing spondylitis: a psychometric analysis. Arthritis Rheum. 2002;47(8):8–16.

    Article  PubMed  Google Scholar 

  • Ware JE, Shelbourne CD. The MOS-36 item short form health survey (SF-36). Med Care. 1992;30:473–83.

    Article  PubMed  Google Scholar 

  • Wolfe F, Michaud K, Li T. Sleep disturbance in patients with rheumatoid arthritis: evaluation by medical outcomes study and visual analogue sleep scales. J Rheumatol. 2006;33:1942–51.

    PubMed  Google Scholar 

  • Wu Q, Inman RD, Davis KD. Tumor necrosis factor inhibitor therapy in ankylosing spondylitis: differential effects on pain and fatigue and brain correlates. Pain. 2015;156(2):297–304.

    Article  CAS  PubMed  Google Scholar 

  • Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia related symptoms with the functional assessment of cancer therapy measurement system. J Pain Symptom Manag. 1997;13(2):63–74.

    Article  CAS  Google Scholar 

  • Yigit S, Sahin Z, Eroglu Demir S, Aytan DH. Home based exercise therapy in ankylosing spondylitis: short-term prospective study in patients receiving tumor necrosis alpha inhibitors. Rheumatol Int. 2013;33:71–7.

    Article  CAS  PubMed  Google Scholar 

  • Zonana-Nacach A, Roseman JM, McGwin G Jr, Friedman AW, Baethge BA, Reveille JD, Alarcón GS. Systemic lupus erythematosus in three ethnic groups. VI: Factors associated with fatigue within 5 years of criteria diagnosis. LUMINA Study Group. Lupus in minority populations: nature vs nurture. Lupus. 2000;9(2):101–9.

    Article  CAS  PubMed  Google Scholar 

Further Reading

Download references

Author information

Authors and Affiliations

  1. Rheumatology, Mater Dei Hospital, L-Imsida, Malta

    Doriana Xhaxho

Authors
  1. Doriana Xhaxho
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Doriana Xhaxho .

Editor information

Editors and Affiliations

  1. Midlands Partnership NHS Foundation Trust Haywood Hospital, Stoke-On-Trent, Staffordshire, UK

    Sarah Ryan

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Xhaxho, D. (2020). Managing Fatigue. In: Ryan, S. (eds) Nursing Older People with Arthritis and other Rheumatological Conditions . Perspectives in Nursing Management and Care for Older Adults. Springer, Cham. https://doi.org/10.1007/978-3-030-18012-6_6

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18012-6_6

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18011-9

  • Online ISBN: 978-3-030-18012-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation