{"doi":"10.1111/jgs.17075","title":"Prevalence and severity of perceived mental fatigability in older adults: The Long Life Family Study","abstract":"The recently validated Pittsburgh Fatigability Scale (PFS) Mental subscale improves upon shortfalls in existing global fatigue measures by standardizing mental fatigue to intensity and duration across a range of activities/tasks, thus eliminating self-pacing.1 A next step is to describe the prevalence and severity of perceived mental fatigability by age and sex to foster comparisons across cohorts and health conditions. We hypothesized that prevalence of perceived mental fatigability would be greater with advancing age and PFS Mental scores would be higher for women than men. Of the 2906 Long Life Family study (LLFS) participants from Visit 2 (2014–2017), N = 2361 completed the PFS. Study eligibility, screening, and measurements are published elsewhere.2 The PFS is a self-administered, 10-item tool that measures fatigue anchored to demand tasks in separate physical and mental subscales. The PFS asks participants to indicate the level of tiredness/exhaustion one expects/imagines they would feel after completing activities on a scale from 0 (“no fatigue”) to 5 (“extreme fatigue”). Responses were summed to derive PFS Mental scores (0–50), higher score = more severe fatigability.3 Missing scores were imputed (n = 140).4 Established cut points were applied to construct PFS Mental score severity strata: 0–3, 4–7, 8–12, 13–15, 16–19, and ≥20.5 Participants with PFS Mental scores ≥13 were classified as having greater perceived mental fatigability.5 We examined age and sex differences using generalized estimating equations (GEEs) with an exchangeable covariance matrix accounting for family relatedness and adjusted for field center.2 Linear trends for PFS Mental scores and prevalence of greater perceived mental fatigability were evaluated across age strata (60–69, 70–79, 80–89, and 90–108 years) and by sex and education. Differences in sample characteristics across PFS Mental score severity strata were tested using GEEs. Overall, the sample was 73.6 ± 10.5 years (range 60–108 years), 99.6% white, and 55% women (Table S1). Those with the most severe mental fatigability (PFS Mental scores ≥ 20) were less educated, had lower physical activity, slower gait speed, worse cognitive function, and greater depressive symptomatology (p < 0.001 for all) after adjustment (Tables S1 and S2). PFS Mental scores skewed right (Figure S1) and were 3.4-fold higher from the youngest (60–69 years) to the oldest (90–108 years) age strata (p < 0.001, Figure 1A and Table S2). When stratified by age and sex, mean PFS Mental scores were higher for women compared with men both overall (p = 0.003) and in the oldest age strata (p = 0.03, Figure 1A and Table S2). Prevalence of perceived mental fatigability (PFS ≥ 13) was greater with advanced age (14.5% for 60–69 years to 67.2% for those 90–108 years, p < 0.001) and was similar between women and men, although sex differences in prevalence widened across older age strata (Figure 1B). Note: p-values between sex account for family relatedness and are adjusted for field center. p-value for linear trend < 0.001 for PFS Mental scores and greater perceived mental fatigability across age strata, overall and for women and men The prevalence of perceived mental fatigability was strikingly greater with age, and women in the oldest age strata were at risk for the most severe PFS Mental scores. Overall mean PFS Mental scores for LLFS (8.4 points) were lower than those from two small studies of healthy older adults by Burke et al.6 (mean age = 74.1 years, N = 35, PFS = 14.0 points) and Carlozzi et al.7 (mean age = 53.4 years, N = 86, PFS = 10.2 points). Overall prevalence of greater perceived mental fatigability (24.8%) was comparable with the Baltimore Longitudinal Study of Aging (22.6%),5 despite LLFS having a larger proportion of the oldest-old. The trend of higher PFS Mental scores with age was expected, as aging is associated with decreased physical function that may cause increased cognitive strain due to higher energy expen","journal":"Journal of the American Geriatrics Society","year":2021,"id":171486,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":26,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9579,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":706947,"name":"Alexa J. Meinhardt","orcid":null,"position":1,"is_corresponding":false},{"id":407423,"name":"Theresa Gmelin","orcid":"0000-0003-1507-6297","position":2,"is_corresponding":false},{"id":407422,"name":"Yujia Qiao","orcid":"0000-0001-7356-3320","position":3,"is_corresponding":false},{"id":460926,"name":"Kyle Moored","orcid":"0000-0001-8938-6357","position":4,"is_corresponding":false},{"id":706948,"name":"Ryan D. Katz","orcid":null,"position":5,"is_corresponding":false},{"id":408271,"name":"Sharon W Renner","orcid":null,"position":6,"is_corresponding":false},{"id":130042,"name":"Nancy W. Glynn","orcid":"0000-0003-2265-0162","position":7,"is_corresponding":false},{"id":706185,"name":"Rebecca W. Cohen","orcid":"0000-0002-4201-6938","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-18T23:46:33.067299Z","pmid":"33675035","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}