Understanding the causes of fatigue in older people
Causes of fatigue in older adults
Fatigue is commonly experienced by older adults for a variety of reasons, sometimes due to weary muscles that develop with age, other times due to an underlying medical issue that can be treated to improve symptoms. Here, we will explore the most common causes of fatigue in older people, how to improve it, when fatigue could be cause for concern, and how home care could assist.
At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about fatigue in older people, we can help.
Why is fatigue more common in older adults?
Fatigue is an intense feeling of tiredness, and anyone at any age can experience this due to lack of sleep, poor nutrition, unhealthy lifestyle choices, emotional stress, overexercising and more. For older people, fatigue may be a regular part of their daily life, as over time the body starts to lose energy, durability and muscle mass (sarcopenia). Other reasons older people may experience fatigue include:
- Chronic health conditions (more common in older age groups)
- Medications causing side effects
- Sleep disturbances causing tiredness during the day
- Poor mental health, such as depression or loneliness
Fatigue is more common in the older population, but you do not need to live with this symptom if you can identify the cause and make changes. By seeking the help of a medical professional and making certain lifestyle changes, you may be able to address your fatigue and improve your quality of life.
What might cause fatigue in an older person?
A number of health conditions and lifestyle factors can lead to fatigue in older adults, either directly or indirectly.
Health Conditions
- Arthritis – The joint pain associated with arthritis can lead to fatigue, and one UK study found over 80% of people with rheumatoid arthritis experienced fatigue.
- Diabetes – Both controlled and uncontrolled diabetes can lead to fatigue due to a combination of medical, endocrine, lifestyle factors and more.
- Heart conditions – Those living with heart disease may experience regular fatigue, either due to the condition itself or the associated medications used to manage it.
- Medication side effects – Antidepressants, blood pressure medications like diuretics and cancer drugs like bisphosphonates are just some of the medications that can cause side effects including fatigue.
- Medical treatments – As well as medications, other medical treatments can cause fatigue such as chemotherapy for cancer, or major surgeries.
- Sleep issues – Sleep conditions like insomnia, sleep apnea and restless leg syndrome limit the amount of restful sleep an older person gets each night, which may leave them feeling fatigued during the day.
- Thyroid dysfunction – Fatigue is a common symptom of thyroid dysfunction due to its effects on sleep, which might include sleep apnea or insomnia for hypothyroidism, or night sweats for hyperthyroidism.
- Illness – Infections common in older people like urinary tract infections (UTIs), as well as common illnesses like flu and COVID-19, can deplete the immune system and affect energy levels leading to fatigue symptoms.
- Nutritional deficiencies – Poor nutrition such as low iron (anemia) or a vitamin B12 deficiency could lead to feelings of fatigue and low energy levels.
- Mental health issues – Conditions like depression and anxiety may impact sleep and energy levels, leaving older people with a feeling of fatigue. Studies have found conditions like depression can even lead to increased inflammatory activation of the immune system, which is connected to fatigue symptoms.
Lifestyle Factors
- Reduced physical activity or a sedentary lifestyle can lead to muscle loss in older adults, known as sarcopenia. With reduced muscle mass, older people may experience fatigue faster or more frequently than younger age groups.
- More general mental health factors such as loneliness, grief or stress can reduce energy levels and lead to feelings of tiredness and fatigue at any age. In older adults, these factors may be compounded by changes to their daily routine, loss of social connections, or major life events like losing friends, so it is important to address both emotional and physical wellbeing.
- Poor sleep is of course linked to feelings of fatigue, as lack of sleep at night can make older people feel overly tired during their waking hours.
- Unhealthy behaviours like smoking, excess alcohol consumption or eating a lot of processed foods can lead to reduced energy levels and general lethargy, especially when it is not counteracted by nutritious foods like leafy greens and lean proteins.
How can an older person improve fatigue symptoms?
If the underlying cause of fatigue is a health condition, the first step is to visit your GP and begin treating the root cause in an attempt to eliminate tiredness. However, if there are no health concerns and fatigue is thought to be a lifestyle issue, a few small changes to your usual routine could see a massive improvement in fatigue symptoms. These include:
- Reviewing your medications – Your doctor will likely do this as part of their investigation. If any of the medications you currently take have fatigue as a side effect, they may look into alternatives or adjust your dosage to minimise side effects.
- Improving your sleep – The importance of quality sleep cannot be overstated, even for older people who may not sleep as many hours a night as they once did. If you suffer from sleep issues like sleep apnea or insomnia, you should speak to a doctor about this to find out if they can help. Even if you do not have specific sleep issues, getting consistent rest is helpful in minimising fatigue symptoms. Ensure your bedroom is cool and your mattress is comfortable. Stick to the same bedtime every night and avoid daytime naps. Use sleep aids like white noise to help you doze off. If you struggle to get to sleep, read a book or meditate instead of using bright screens. You can learn more in our guide to: healthy sleep and insomnia in the elderly.
- Staying active – Many older people suffer from physical health conditions that limit their ability to move around as they once did, but it is still important to stay active throughout the day to promote tiredness at night, leading to better sleep and less fatigue. Getting regular gentle exercise like walking or swimming helps to boost energy and oxygen levels, and reduce feelings of fatigue. You can learn more in our guide to fitness and exercise for the elderly.
- Eating nutritious foods – Our nutrition has a direct link to our energy levels. By eating a diet rich in nutritious fruits, vegetables, whole grains and more, and avoiding excess sugar and processed foods, you may start to feel a difference in energy. Speak to your doctor about your diet so they can recommend supplements to fill any gaps in your nutrition and improve fatigue symptoms faster. Staying hydrated is also vital, so take steps to drink more water, tea and other liquids throughout the day. You can read more about this in our guide to the symptoms of dehydration in the elderly.
- Avoiding unhealthy lifestyle choices – Habits like smoking or drinking too much can contribute to fatigue, so cut these out as much as possible. One 2021 study found that 14 days of no tobacco use improved muscle fatigue resistance and reversed markers of systemic inflammation in subjects who previously smoked, showing how lifestyle changes can have positive impacts.
- Managing stress levels – Stress can have unexpected effects on the physical body, and it is possible for excessive stress and mental health issues to contribute to fatigue. If there is something stressful going on in your life that you can eliminate, do so. This could give you less anxiety, more energy, and a renewed sense of wellbeing.
Asking for help – Feelings of fatigue can be the result of overexertion in daily life. If you are starting to struggle with things like housework, getting out and about on your own, or cooking, don’t avoid asking for help. Reach out to loved ones for assistance, or speak to your local council to find out what help might be available to you. You can learn more in our guide on how to choose and arrange home care services.
What about sudden and extreme fatigue?
It is important to note that while general fatigue is normal or associated with a non-urgent health condition, sudden and extreme fatigue can be something different. If fatigue is severe enough that it significantly impacts an older person’s abilities, the underlying cause must be addressed as soon as possible.
This could be an indication of a health condition affecting the heart, such as heart disease, which is a possibility if symptoms like shortness of breath or chest pains are also present. In addition, sudden, extreme fatigue could be a sign of an infection like pneumonia, severe anaemia, diabetes, stroke, neurological issues or something else.
In these instances, you should seek medical help straight away as this could be an emergency, and if your extreme fatigue persists for at least 3 months, the NHS recommends seeking help to find out the underlying cause.
You can read more about this in our guide to what causes sudden extreme fatigue in the elderly.
When should someone see a doctor for fatigue?
As above, sudden fatigue should be evaluated by a doctor straight away, and extreme fatigue lasting more than 3 months should also be checked. If you have general fatigue and low energy lasting more than a few weeks, don’t be afraid to seek advice from your GP to find out if there is anything underlying, particularly if the fatigue follows an infection or medical procedure. It could be something as simple as a vitamin deficiency that can be fixed with supplements, or they may suggest further tests or treatments.
If your fatigue is accompanied by other symptoms like shortness of breath, a fever, chest pain, dizziness, headaches or unexplained weight loss, reach out to your doctor to check everything is as it should be.
How can home care help older adults who suffer from fatigue?
Home care is a great support for older people with fatigue symptoms, whether these are temporary or present on a long-term basis. Our Care Professionals at Home Instead can help with a number of daily tasks, including:
- Providing personalised assistance to reduce daily exertion
- Encouraging more movement (if recommended by a doctor) to increase energy
- Helping with medication schedules
- Encouraging better quality sleep
- Preparing nutritious meals
- Assistance getting out of the house for socialisation and exercise
- Providing emotional support and companionship to minimise loneliness and isolation
- Monitoring fatigue symptoms if associated with a specific health condition
If you are suffering from fatigue–whether mild or debilitating–our highly trained Care Professionals are experienced in helping ease the burden to reduce fatigue. From general companionship and mobility care to complex care and home help, whatever support you need, you can reach out to your local Home Instead office to discuss your options.
We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.