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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Advance Access published online on June 15, 2009
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, doi:10.1093/gerona/glp073
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© The Author 2009. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Development and Validation of a New Questionnaire for the Evaluation of Upper Gastrointestinal Symptoms in the Elderly Population: A Multicenter Study

Alberto Pilotto1, Stefania Maggi2, Marianna Noale2, Marilisa Franceschi1, Giancarlo Parisi3, Gaetano Crepaldi2 and on behalf of the IPOD Investigators

1 Department of Medical Sciences, Geriatric Unit and Gerontology-Geriatrics Research Laboratory, IRCCS "Casa Sollievo della Sofferenza," San Giovanni Rotondo, Italy
2 Aging Section, Institute of Neurosciences, Department of Medicine, National Research Council, Padova, Italy
3 Department of Internal Medicine, General Hospital, Feltre, Italy

Address correspondence to Alberto Pilotto, MD, Director of the Department of Medical Sciences, Geriatric Unit and Gerontology-Geriatrics Research Laboratory, IRCCS "Casa Sollievo della Sofferenza," Viale Cappuccini 10, 71013 San Giovanni Rotondo, Foggia, Italy. Email: alberto.pilotto{at}operapadrepio.it


  Abstract

Background: Several diagnostic questionnaires for evaluating upper gastrointestinal symptoms have been described; none of these, however, has been validated in older individuals.

Objectives: To develop and validate a diagnostic tool for evaluating upper gastrointestinal symptoms in older patients.

Methods: A cohort of 206 older patients who underwent a upper gastrointestinal endoscopy (development cohort) was used for developing a 15-item upper gastrointestinal symptom questionnaire for the elderly population (UGISQUE), including five symptom clusters: (a) abdominal pain syndrome, (b) reflux syndrome, (c) indigestion syndrome, (d) bleeding, and (e) nonspecific symptoms. The questionnaire was then validated in a cohort of 326 older patients selected from those who underwent an upper gastrointestinal endoscopy in 15 gastroenterological centers in Italy (validation cohort).

Results: The endoscopic diagnoses in the development and validation cohorts were esophagitis (E) 15.5% and 29.4%, erosive gastritis (EG) 24.8% and 24.8%, peptic ulcer (PU) 26.2% and 14.7%, and without organic lesions (WOL) 31.0% and 33.5%, respectively. In both the cohorts, patients with upper gastrointestinal disorders showed significantly more symptoms than WOL patients. The predictive value of UGISQUE for any pathological condition (E, EG, or PU) was good, with areas under the receiver-operating characteristic curve of .80, 95% confidence interval (CI) 0.743–0.864, and of .78, 95% CI 0.73–0.83, in the development and validation cohorts, respectively. The accuracy of UGISQUE was significantly higher than that for the individual clusters of symptoms in predicting the presence of E (p = .004), PU (p < .0001), or any pathological condition (p < .0001).

Conclusion: UGISQUE is an accurate diagnostic tool for evaluating symptoms in elderly patients with upper gastrointestinal disorders.

Keywords Gastrointestinal symptoms; Esophagitis; Peptic ulcer; Gastritis; Elderly population

Received: February 4, 2009; Accepted: April 27, 2009

Decision Editor: Luigi Ferrucci, MD, PhD


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