Chronic Illness and Fatigue in Older Individuals: A Systematic Review.

The review used narrative synthesis, not meta-analysis, because the studies were too different to combine. Only four databases were searched, in English, and gray literature was excluded, so relevant studies may be missing. Included studies used different fatigue measures and measured different aspects of fatigue, so findings were hard to compare. Most included studies were observational, so they could not show that any factor caused fatigue. Treatment evidence was narrow. One RCT studied chronic anemia, and one RCT studied acetyl-L-carnitine in older adults with fatigue, so findings may not apply to all chronic illnesses. Medication associations came from one study and did not report doses, so they cannot guide medication changes. Qualitative findings came mainly from women with heart failure, and steps for rigor were not fully reported.

The authors declared no conflict of interest. The development was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number P20NR016599. The content is solely the authors' responsibility and does not necessarily represent official NIH views.

Do not conclude that exercise, acetyl-L-carnitine, or epoetin alfa is proven to reduce fatigue in all older adults with chronic illness. Most included studies were observational, and the treatment findings came from small studies in specific conditions, so they do not establish general effectiveness.