The relationship between symptoms of chronic disease and dependence

A total of 2705 people aged 60 years and over were sent a postal questionnaire requesting information about the symptoms of four common conditions--exertional chest pain, chronic productive cough, breathlessness, and exertional pain in the calves. These were elicited using a standardized questionnaire. The effect of these symptoms on the dependence of those suffering them was assessed in relation to a series of activities associated with normal daily living. There was a consistent rank order in the activities that people were unable to perform for the different symptoms studied, but this order altered with increasing severity and multiple symptoms. There was a consistency about the activities which changed order. It is suggested that symptoms and their associated dependence need to be assessed in relation to each other, using simple scaling systems by professional service personnel, managers/, and planners, in order to bring together the therapeutic rehabilitative, and social aspects of health needs. These are felt to be vital before decisions about service development can be made.