Diagnosis and assessment of somatic symptom and related disorders among older adults: Issues and strategies

The limited understanding and literature concerning somatic symptom and related disorders (SSRDs), especially in older adults, further complicates accurate and sensitive diagnosis and assessment for this growing and specialized population. As the population of older adults is expected to grow exponentially, the purposes of this paper are to identify and elucidate key diagnostic and assessment challenges for SSRDs among older individuals to inform further research and guide practice. This paper also describes common self-report measures for SSRDs and describes the psychometric evidence for the use of these measures with older adults. Regarding diagnosis, older adults have higher rates of somatic multimorbidity and can incorrectly attribute somatic symptoms to normal aging. Furthermore, cognitive impairment rates are higher in older adults, impacting the accuracy of reporting SSRD symptoms. Regarding assessment, there are no elder-specific measures of SSRDs. Moreover, few of the current SSRD measures have been specifically validated for use with older adults. In addition, due to lack of education and awareness, mental health clinicians and medical providers may hold stigmatizing views of older adults with SSRD symptoms. The complex symptom presentation of SSRDs in older adults also complicates the efficacy of assessments. The paper concludes with suggestions for further research on SSRDs with diverse older adult populations.