Primary Care Management of Medically Unexplained Symptoms in Older Adults
Date of Award
Spring 2025
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Zachary T. Weik DSc, MHS, PA-C
Abstract
The objective of this continuing medical education article is to update primary care providers (PCP) regarding the presentation, identification, and management of older adults with somatic symptom and related disorders, a group of conditions characterized by multiple somatic symptoms. Diagnosis poses a challenge because somatic symptoms may be vague, lack organic etiology, or be psychogenic in origin. Due to several factors, including PCP fear of overlooking a serious illness, diagnosis is especially difficult in older adults. PCPs are uniquely situated to mitigate the harms of somatic symptom disorders in older adults given their standing relationships and more frequent encounters with patients compared to other specialized providers. This article identifies key risk factors, history and physical examination findings, and diagnostic techniques to aid in making a diagnosis. An algorithm is provided to inform subsequent management. Included are recommendations on patient counseling and education, which is regarded as one of the most effective interventions. PCPs will continue to encounter geriatric patients with multiple somatic symptoms, and they should incorporate these recommendations into their practice.
Recommended Citation
Smee, Martha E., "Primary Care Management of Medically Unexplained Symptoms in Older Adults" (2025). Capstone Showcase. 20.
https://scholarworks.arcadia.edu/showcase/2025/pa/20
Primary Care Management of Medically Unexplained Symptoms in Older Adults
The objective of this continuing medical education article is to update primary care providers (PCP) regarding the presentation, identification, and management of older adults with somatic symptom and related disorders, a group of conditions characterized by multiple somatic symptoms. Diagnosis poses a challenge because somatic symptoms may be vague, lack organic etiology, or be psychogenic in origin. Due to several factors, including PCP fear of overlooking a serious illness, diagnosis is especially difficult in older adults. PCPs are uniquely situated to mitigate the harms of somatic symptom disorders in older adults given their standing relationships and more frequent encounters with patients compared to other specialized providers. This article identifies key risk factors, history and physical examination findings, and diagnostic techniques to aid in making a diagnosis. An algorithm is provided to inform subsequent management. Included are recommendations on patient counseling and education, which is regarded as one of the most effective interventions. PCPs will continue to encounter geriatric patients with multiple somatic symptoms, and they should incorporate these recommendations into their practice.