Does age matter in Psoriatic arthritis? A narrative review

Abstract

Psoriatic arthritis (PsA) affects about 0.8% of the general population. Together with psoriasis is termed psoriatic disease. Comorbidities play an important role in the clinical expression and treatment of psoriatic disease. Ageing adds another level of complexity, partly because age directly accrues increasing risk of comorbidities, but also due to its complex interactions with several factors such as depression and social determinants. Ageing seems to have a "paradoxical association" with cardiovascular comorbidities for which the relative risk is more pronounced in younger patients with psoriatic disease and also to affect treatment decisions and response in patients with psoriatic disease. Finally, there is convincing evidence that there are clinical, genetic and histopathological differences between young- and late- onset PsA and psoriasis. Herein, we review the effect of age in patients with psoriatic disease, with a focus on PsA, highlighting the need to consider this feature in routine clinical practice as well as in the research domain.