Rheumatology

Many rheumatic diseases disproportionately affect older individuals. Osteoarthritis is almost universally present among octogenarians, and giant cell arteritis, the most common systemic vasculitis in North America, occurs exclusively in individuals over the age of 50 with a mean age of onset between 70 and 80 years. Rheumatoid arthritis has a prevalence of 2% in the USA among individuals over the age of 60. Rheumatic, autoimmune, and musculoskeletal diseases may be common among older individuals, but the care of these patients is far from routine. Rheumatic diseases, and the medications used to treat them, often affect muscles and joints. This has a profound and unique impact on older individuals who are often already dealing with aging-related musculoskeletal issues that are the consequence of multiple co-morbidities, poor functional status, malnutrition, sarcopenia, and cognitive impairment. This chapter reviews epidemiologic, diagnostic, and therapeutic data for some of the most common rheumatic conditions among older individuals (arthritis, myositis, vasculitis, and connective tissue disorders). By highlighting some of the important unanswered questions in the multifaceted care of older patients with rheumatic disease we hope to generate future investigation in these areas.