INTRODUCTION/PURPOSE Fatigue is an established prognostic indicator of mortality risk. It remains unknown whether fatigability anchored to a physical task is a more sensitive prognostic indicator and whether sensitivity differs by prevalent chronic conditions. METHODS 1,076 physically well-functioning participants aged ≥50 years in the Baltimore Longitudinal Study of Aging self-reported fatigue (unusual tiredness or low energy) and had perceived fatigability assessed after a standardized treadmill walk. All-cause mortality was ascertained by proxy contact and National Death Index linkage. Cox proportional hazards models estimated associations of perceived fatigability and fatigue with all-cause mortality, adjusting for demographic and clinical covariates. Interactions by chronic conditions were also examined. ResultsEach one-standard deviation higher in perceived fatigability, unusual tiredness, or low energy was associated with a higher relative hazard of all-cause mortality after covariate adjustment (fatigability: HR = 1.18, 95% CI: 1.03-1.36; unusual tiredness: HR = 1.25, 95% CI: 1.08-1.44; low energy: HR = 1.27, 95% CI: 1.10-1.46). Models had similar discrimination (p > 0.14 for all). Perceived fatigability was associated with mortality risk among participants free of arthritis or osteoarthritis who otherwise appeared healthy (no arthritis: HR = 1.45, 95% CI: 1.15-1.84; arthritis: HR = 1.09, 95% CI: 0.92-1.30; p-interaction = 0.031). Unusual tiredness was associated with mortality among those with a history of diabetes (no diabetes: HR = 1.16, 95% CI: 0.97-1.38; diabetes: HR = 1.65, 95% CI: 1.22-2.23; p-interaction = 0.045) or pulmonary disease (no pulmonary disease: HR = 1.22, 95% CI: 1.05-1.43; pulmonary disease: HR = 2.15, 95% CI: 1.15-4.03; p-interaction = 0.034). CONCLUSIONS Higher perceived fatigability and fatigue symptoms were similarly associated with higher all-cause mortality, but utility differed by chronic condition. Perceived fatigability might be useful for health screening and long-term mortality risk assessment for well-functioning adults. Alternatively, self-reported fatigue appears more disease-specific with regards to mortality risk.

中文翻译：

---

巴尔的摩老龄化纵向研究中中晚年的感知疲劳、疲劳和死亡率。

简介/目的疲劳是死亡风险的既定预后指标。目前尚不清楚与体力任务相关的疲劳是否是一个更敏感的预后指标，以及敏感性是否因流行的慢性病而不同。方法 巴尔的摩衰老纵向研究中的 1,076 名身体机能良好、年龄≥50 岁的参与者自我报告疲劳（异常疲倦或精力不足），并在标准化跑步机行走后评估疲劳程度。全因死亡率是通过代理联系和国家死亡指数联系来确定的。Cox 比例风险模型估计了感知疲劳和疲劳与全因死亡率的关联，并根据人口统计和临床协变量进行了调整。还检查了慢性病的相互作用。结果 感知疲劳、异常疲劳或低能量每增加一个标准差，协变量调整后全因死亡率的相对风险就会升高（疲劳性：HR = 1.18，95% CI：1.03-1.36；异常疲劳：HR = 1.25，95% CI：1.08-1.44；低能量：HR = 1.27，95% CI：1.10-1.46）。模型具有类似的歧视（所有模型均 p > 0.14）。在没有关节炎或骨关节炎但看上去健康的参与者中，感知的疲劳性与死亡风险相关（无关节炎：HR = 1.45，95% CI：1.15-1.84；关节炎：HR = 1.09，95% CI：0.92-1.30；p-相互作用= 0.031）。有糖尿病史的患者中，异常疲劳与死亡率相关（无糖尿病：HR = 1.16，95% CI：0.97-1.38；糖尿病：HR = 1.65，95% CI：1.22-2.23；p 交互作用 = 0.045）或肺部疾病（无肺部疾病：HR = 1.22，95% CI：1.05-1.43；肺部疾病：HR = 2.15，95% CI：1.15-4.03；p 交互作用 = 0.034）。结论 较高的感知疲劳度和疲劳症状同样与较高的全因死亡率相关，但效用因慢性病而异。感知疲劳可能有助于功能良好的成年人的健康筛查和长期死亡风险评估。另外，就死亡风险而言，自我报告的疲劳似乎更具疾病特异性。