TY - JOUR
T1 - Challenges in the management of older patients with inflammatory rheumatic diseases
AU - van Onna, M.
AU - Boonen, A.
N1 - Funding Information:
M.v.O. has received consultancy fees from Novartis and Pfizer and a research grant from Pfizer. A.B. has received research grants to her department from AbbVie and Celgene and consultancy fees from UCB, Lilly, Novartis, Sandoz and Galapagos.
Publisher Copyright:
© 2022, Springer Nature Limited.
PY - 2022/6
Y1 - 2022/6
N2 - The rise in the number of people aged 65 years and older living with inflammatory rheumatic diseases such as rheumatoid arthritis is causing considerable challenges for clinicians. As patients get older, they are at an increased risk of multiple chronic diseases, a situation termed multimorbidity. Multimorbidity inevitably drives polypharmacy, where by a patient requires treatment with multiple medications. In addition, advancing age, multimorbidity and polypharmacy all place a patient at an increased risk of developing geriatric syndromes, which are clinical conditions in older people that do not fit into disease categories and include malnutrition, sarcopenia and frailty. Geriatric syndromes further increase the risk of adverse outcomes, including the accrual of additional morbidity, nursing home admission and mortality. Patients with inflammatory rheumatic diseases are especially prone to developing geriatric syndromes. Some predisposing risk factors for geriatric syndromes, such as joint swelling and functional limitations, are also inherent to rheumatic inflammatory disease itself. The frequent coexistence of multimorbidity, polypharmacy and geriatric syndromes in this patient group requires individually tailored interventions to preserve patient independence and overall functioning. To prepare for the changing demography, rheumatologists should gain more insight into the implications of multimorbidity, polypharmacy and geriatric syndromes for the management of older patients with inflammatory rheumatic diseases.In this Review, the authors discuss the challenges of multimorbidity, polypharmacy and geriatric syndromes in older patients with inflammatory rheumatic diseases. They note that individually tailored interventions are needed in this patient group in order to preserve patient independence and overall functioning.
AB - The rise in the number of people aged 65 years and older living with inflammatory rheumatic diseases such as rheumatoid arthritis is causing considerable challenges for clinicians. As patients get older, they are at an increased risk of multiple chronic diseases, a situation termed multimorbidity. Multimorbidity inevitably drives polypharmacy, where by a patient requires treatment with multiple medications. In addition, advancing age, multimorbidity and polypharmacy all place a patient at an increased risk of developing geriatric syndromes, which are clinical conditions in older people that do not fit into disease categories and include malnutrition, sarcopenia and frailty. Geriatric syndromes further increase the risk of adverse outcomes, including the accrual of additional morbidity, nursing home admission and mortality. Patients with inflammatory rheumatic diseases are especially prone to developing geriatric syndromes. Some predisposing risk factors for geriatric syndromes, such as joint swelling and functional limitations, are also inherent to rheumatic inflammatory disease itself. The frequent coexistence of multimorbidity, polypharmacy and geriatric syndromes in this patient group requires individually tailored interventions to preserve patient independence and overall functioning. To prepare for the changing demography, rheumatologists should gain more insight into the implications of multimorbidity, polypharmacy and geriatric syndromes for the management of older patients with inflammatory rheumatic diseases.In this Review, the authors discuss the challenges of multimorbidity, polypharmacy and geriatric syndromes in older patients with inflammatory rheumatic diseases. They note that individually tailored interventions are needed in this patient group in order to preserve patient independence and overall functioning.
KW - ELDERLY-PATIENTS
KW - COGNITIVE IMPAIRMENT
KW - GERIATRIC SYNDROMES
KW - PSORIATIC-ARTHRITIS
KW - SERIOUS INFECTIONS
KW - RISK-FACTORS
KW - FRAILTY
KW - PREVALENCE
KW - POPULATION
KW - ETANERCEPT
U2 - 10.1038/s41584-022-00768-6
DO - 10.1038/s41584-022-00768-6
M3 - (Systematic) Review article
C2 - 35314796
SN - 1759-4790
VL - 18
SP - 326
EP - 334
JO - Nature Reviews Rheumatology
JF - Nature Reviews Rheumatology
IS - 6
ER -