The Prevalence of Cardiopulmonary Symptoms Among Chinese Older Adults in the Greater Chicago Area

Symptoms may influence an individual’s perception of their overall health and quality of life (1). Cardiovascular and pulmonary symptoms in particular, may cause physical discomfort and negative psychological consequences among older adults (2). Functionally, the cardiovascular and pulmonary systems interact with each other. Thus, rather than attributing symptoms to a single disease, evaluating cross-disease symptoms with the cardiovascular and pulmonary systems can provide a better reflection of the clinical effects and health burden of multiple cardiovascular and pulmonary diseases and conditions. Older adults are often at higher risk for cardiovascular and pulmonary disorders. Notably, in the United States, cardiovascular disease is the leading cause of death among people aged 65 and older and chronic lower respiratory diseases are the third leading cause (3). Aging in conjunction with physical, psychological, and behavioral changes often contribute to multiple cardiovascular and pulmonary conditions and their resulting symptoms (4). As 50% of older adults aged 60 or older live with one or more chronic condition, identifying and alleviating cardiovascular and pulmonary symptoms experienced by older adults is an important goal in multiple chronic diseases management (5). However, although several studies have evaluated the prevalence of diagnosed cardiovascular and pulmonary conditions, insufficient efforts have been made on assessing the prevalence and role of symptoms in older adults’ daily lives. Most prior studies were based on single symptom and single disease or single disease set, like cancer, heart failure, or chronic pulmonary diseases (2,6), and often did not assess the overall systematic symptom burden caused by multiple chronic conditions. Moreover, although a number of prior studies assessed the prevalence of symptoms among older patients with advanced chronic diseases, very few population-based studies have focused on the symptoms experienced by general community-dwelling older adults (7,8). In particular, underrepresented minority older adults in the United States may be disproportionately affected by cardiovascular and pulmonary disorders. National statistics indicate that a higher percentage of Asian Americans died because of cardiovascular diseases compared with whites and Hispanic (9). However, Asian Americans are consistently treated as a homogeneous group, which fails to acknowledge differences in cultural beliefs, health behaviors, and genetic inherence among diverse Asian subgroups (10). The demographic shifts and rapid growth of Chinese older adults in the United States warrant a better understanding of their cardiovascular and pulmonary symptoms. The Chinese community is the oldest and largest Asian American subgroup in the United States (11). However, the vast intragroup diversity in language, education level, socioeconomic status, and degree of acculturation among U.S. Chinese older adults have resulted in limited evidence-based research targeting this group (12). To build upon the social and health issues documented in previous research with U.S Chinese older adults (13–15) and paint their overall health burden, there is a need to assess the presence of clinical symptoms experienced by this population. In this study, we aim to (i) evaluate the prevalence of cardiovascular and pulmonary symptoms within the context of a large population-based cohort of U.S. Chinese older adults; (ii) examine the correlations between cardiovascular and pulmonary symptoms and sociodemographic characteristics; and (iii) examine the correlations between cardiovascular and pulmonary symptoms and self-reported health and quality of life measures.