Why do I always feel tired?" Evaluating older patients reporting fatigue

Fatigue is a common symptom in elderly persons, but it is often ignored as many patients and healthcare providers assume it is a natural progression of aging or may mistake it for somnolence, dyspnea, or muscle weakness. Since its importance is often underestimated, patients with fatigue may not receive an intervention, potentially resulting in significant functional decline. This article discusses the importance of identifying the underlying etiology or etiologies of a patient's fatigue so that it can be eliminated, if possible, or managed appropriately. History-taking, including consideration of the patient's symptom severity, is the most important part of evaluating fatigue. The authors present an algorithm that can be used to help identify the cause of a patient's fatigue.