Rheumatic diseases in the elderly: Challenges and management

Abstract

Abstract The elderly demographic is seeing a gradual rise as a proportion of the overall global population, whilst also experiencing high rates of musculoskeletal issues, requiring specialized care. The management of rheumatic diseases in the elderly presents unique challenges due to the complex interplay among physiological changes, cognitive decline, and altered immune responses. Such conditions can be categorized into those progressing from earlier life stages (such as rheumatoid arthritis, systemic lupus erythematosus, spondyloarthritis, and gout) and those predominantly emerging in old age (such as polymyalgia rheumatica, giant cell arteritis, osteoarthritis, crystal arthropathies, and osteoporosis), each with distinct characteristics and management needs. These diseases often present atypically with nonspecific symptoms and altered serological markers, complicating diagnosis and management due to increased toxicity risks and comorbidities. Comprehensive, multidisciplinary care that includes cardiovascular health monitoring, bone density maintenance, gastrointestinal tolerance management, infection prevention, and mental health support are essential to improve outcomes and quality of life for elderly patients with rheumatic diseases.