Geriatric rheumatology:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2000
|
| Schriftenreihe: | Rheumatic disease clinics of North America
26,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 415 - 691 Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
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| adam_text | GERIATRIC RHEUMATOLOGY
CONTENTS
Preface xi
Richard F. Loeser, Jr and Kenneth S. O Rourke
Geriatric Assessment for the Rheumatologist 415
Paul E. McGann
The population of industrialized countries is aging rapidly. Rheu
matologic disorders are the most common illnesses causing func¬
tional disability in the elderly and medications for rheumatologic
disorders are among the most frequently prescribed. As the popu¬
lation of patients seen by rheumatologists ages, it is important
for the rheumatologist to understand the techniques of geriatric
assessment that are useful in understanding and treating this
special population. This article reviews practical ways to assess
function, cognition, affect, directives, and end of life care in el¬
derly populations. The article concludes with a Top Ten list of
geriatric principles for rheumatology fellows to learn.
Geropharmacology for the Rheumatologist 433
Lydia A. Percy and Meika A. Fang
Drug administration to older patients with rheumatic disease is a
challenge because they are more likely to have adverse drug
reactions compared with younger patients. Elderly patients are at
risk for adverse drug effects because they often have multiple
acute and chronic illnesses and are on several prescription and
over the counter medications. This article will enhance the prac¬
titioner s understanding of how disease and age modulate the
pharmacokinetics and pharmacodynamics of medications com¬
monly prescribed for rheumatic disorders. Minimizing the num¬
ber of drugs prescribed, starting medications at low doses and
increasing slowly, and monitoring for toxicity are especially im
RHEUMATIC DISEASE CLINICS OF NORTH AMERICA
VOLUME 26 • NUMBER 3 • AUGUST 2000 V
portant in the elderly. With judicious use of medications, the
quality of life of older patients with rheumatic disease can be
enhanced.
Changes in Immune Function with Age 455
Raymond L. Yung
Aging is accompanied by a decline in the effectiveness of a
number of immune functions. This has been termed immunosen
escence . Changes identified to date suggest that the major de¬
fects reside in the T cell immune compartment. Recent research
also suggests that alteration in B cell and other immune cells may
play an important role in defining the immune competency in
the elderly. These changes have been linked to reduced responses
to immunization, and increased rate of infection, cancer, and
mortality in aging. In the era of the aging baby boomers, it is
important for all clinicians to understand these changes and their
implications.
Systemic Lupus Erythematosus in the Elderly 475
Gary M. Kammer and Nilamadhab Mishra
Systemic lupus erythematosus (SLE) is an autoimmune disease of
indeterminate etiology characterized by an abnormal cellular and
humoral immune response. It is currently believed that SLE is a
multigenic disease in which environmental factors are likely to
modulate expression of disease susceptibility genes. The clinical
presentation of SLE in the elderly differs, however, from that in
the early onset disease. This article reviews recent information
about the epidemiology, clinical presentation, laboratory and ra
diographic findings, immune response, and treatment and prog¬
nosis in late onset SLE.
Polymyalgia Rheumatica and Giant Cell Arteritis 493
Jonathan M. Evans and Gene G. Hunder
Giant cell (temporal) arteritis and polymyalgia rheumatica are
among the most common chronic inflammatory disorders in older
adults. Recent work has provided new information about the
clinical features and pathophysiology of these diseases, and better
ways of detection and treatment. This article provides a general
review of these conditions with a focus on diagnosis and manage¬
ment.
Elderly Onset Rheumatoid Arthritis 517
Yusuf Yazici and Stephen A. Paget
One third of the elderly population acquires rheumatoid arthritis
(RA) after the age of 60, and the prevalence of the condition
vi CONTENTS
increases with advancing age. This statistic is particularly im¬
portant because of the growing population of older persons and
the potential implications for the care of these patients in the
future. If elderly onset RA beginning after 60 years of age is a
distinctly different disorder from younger onset RA, physicians
must be aware of this and the diagnostic and therapeutic signifi¬
cance.
Crystal Associated Arthritis in the Elderly 527
Carlos A. Agudelo and Christopher M. Wise
The understanding of the clinical syndromes of gout and pseu
dogout, and the role of basic calcium crystals in arthritis has
increased since the original descriptions of the involvement of
crystals in arthritis. Gout is usually considered an affliction con¬
fined to middle aged males but has an increasing prevalence in
older populations, with unique and often atypical features. Cal¬
cium pyrophosphate dihydrate crystal deposition disease is com¬
mon in elderly patients. The diagnosis of these common forms of
arthritis and the need to individualize therapy in patients with
other medical problems remain important clinical challenges to
the practicing physician.
Aging and the Etiopathogenesis and Treatment of
Osteoarthritis 547
Richard R Loeser, Jr
Although the incidence and prevalence of osteoarthritis (OA)
increases directly with age, OA is not simply a time dependent
wear and tear process of articular joints. OA results from an
imbalance between anabolic and catabolic processes occurring in
joint tissues. Aging related changes within joint tissues contribute
to the development of OA by making the joint more susceptible
to injury and less able to repair damage. Aging of the musculo
skeletal tissues and aging of other organ systems impacts the
management of OA. The therapeutic approach in older adults
should emphasize methods to improve physical function and
should avoid the use of drugs that have a higher risk for side
effects in older adults.
Osteoporosis: Pathogenesis, Diagnosis, and Treatment in
Older Adults 569
Anne M. Kenny and Karen M. Prestwood
Bone loss due to calcium deficiency, hormonal deficiency, and
imbalance in bone turnover frequently leads to osteoporosis in
older men and women. The diagnosis of osteoporosis can be
made prior to fragility fracture, allowing for prevention and treat¬
ment. In this article, criteria for the diagnosis of osteoporosis, and
a plan for the evaluation of primary and secondary osteoporosis
CONTENTS vii
are discussed. In addition, prevention and treatment options in¬
cluding dietary intake, exercise, and medications are reviewed.
Selected Orthopedic Problems in the Elderly 593
Jeffrey Goldstein and Joseph D. Zuckerman
The elderly are the fastest growing segment of the population.
Degenerative changes that occur in the musculoskeletal system
present themselves in various ways within the elderly population.
The purpose of this article will be to discuss the pathophysiology
and treatment of some of the frequently encountered orthopedic
problems in older adults, including rotator cuff problems, menis
cal injuries, spinal stenosis, arthoplasty, and selected fractures.
Therapeutic and Physical Fitness Exercise Prescription
for Older Adults with Joint Disease: An Evidence Based
Approach 617
Michael O Grady, Jacquelyn Fletcher, and Susan Ortiz
This article reviews the growing evidence regarding the clinical
and physiologic effects of different exercise programs in older
adults with joint diseases. In addition, this article provides the
clinician with basic conceptual framework for developing practi¬
cal exercise prescriptions that are tailored specifically toward the
older adult with joint disease. Recommendations for beginning
and progressing exercise programs are presented.
Myopathies in the Elderly 647
Kenneth S. O Rourke
Muscle disease symptoms and myopathies are not uncommon in
the elderly. Inflammatory and noninflammatory myopathies lead
to proximal extremity or axial weakness and are superimposed
on the intrinsic changes that occur in muscle with aging (sarco
penia). This article surveys the more common myopathies in the
elderly based on a review of the process of sarcopenia, and how
these age related changes in muscle structure and function affect
the results of the standard assessments of muscle disease in
the elderly.
Diffuse Pain Syndromes in the Elderly 673
Kristin M. Gowin
Diffuse pain syndromes are common in the elderly. The most
commonly seen diffuse pain syndromes are fibromyalgia and
polymyalgia rheumatica. Fibromyalgia is a diffuse pain syndrome
with an associated sleep disorder and can occur in any age group
but is more common in the elderly. Polymyalgia rheumatica oc¬
curs only in adults over 50 years of age and involves mostly the
viii CONTENTS
hip and shoulder girdles. These syndromes and other causes of
diffuse pain can easily be confused and may overlap to some
extent. A thorough history and physical examination in combina¬
tion with screening laboratory evaluation may help to differenti¬
ate between syndromes.
Index 683
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CONTENTS *x
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| spelling | Geriatric rheumatology Richard F. Loeser ... Philadelphia [u.a.] Saunders 2000 XII S., S. 415 - 691 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Rheumatic disease clinics of North America 26,3 Maladies de l'appareil locomoteur - Sujet âgé Ouderen gtt Reumatische aandoeningen gtt Rhumatismes - Sujet âgé Aged Rheumatic Diseases Alter (DE-588)4001446-0 gnd rswk-swf Rheumatismus (DE-588)4049836-0 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Alter (DE-588)4001446-0 s Rheumatismus (DE-588)4049836-0 s DE-604 Loeser, Richard F. Sonstige oth Rheumatic disease clinics of North America 26,3 (DE-604)BV000625464 26,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=009092231&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| title | Geriatric rheumatology |
| title_auth | Geriatric rheumatology |
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| title_short | Geriatric rheumatology |
| title_sort | geriatric rheumatology |
| topic | Maladies de l'appareil locomoteur - Sujet âgé Ouderen gtt Reumatische aandoeningen gtt Rhumatismes - Sujet âgé Aged Rheumatic Diseases Alter (DE-588)4001446-0 gnd Rheumatismus (DE-588)4049836-0 gnd |
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