PsA and Aging

The peak age of onset of psoriatic arthritis (PsA) is between 35-55 years.1-5 However, PsA can be diagnosed at any age, including in children and after the age of 60.4,5 Regardless of the age at diagnosis, PsA is a chronic condition and requires lifelong treatment to prevent the disease from getting worse. Thus, it is important to take steps to optimize management of your psoriatic arthritis and overall health.

  1. Attend periodic follow-up visits with your rheumatologist. It is important to complete any requested follow-up bloodwork and joint imaging tests to screen for potential medication side effects and to understand if there has been any worsening of your joint disease over time. 
  2. Keep track of your PsA symptoms and any changes over time. Symptoms such as increased joint swelling, pain and/or morning stiffness are signs of a PsA flare-up. Although many therapies for PsA are highly effective over the long-term, it is possible that some patients may experience their medication becoming less effective and disease worsening after years of having stable disease on their current treatment plan.6 It is important to discuss any worsening of symptoms with your rheumatologist. Your rheumatologist may recommend switching medications or adding an additional medication for a period of time to help put your PsA back into remission. 
  3. Exercise regularly. Studies have shown a beneficial effect of regular exercise on PsA, with a reduction in symptoms such as pain and fatigue.7 If joint pain limits your ability to exercise, working with a physiotherapist may be beneficial to help improve joint mobility.8
  4. Take steps to care for your overall health. It is important to eat a healthy diet, limit alcohol consumption, and avoid or quit smoking.8 You should also visit your family physician at least annually to monitor your overall health. Individuals with PsA are at an increased risk of comorbid conditions such as cardiovascular disease and type 2 diabetes, which are also more common in older individuals.4,8

Ultimately, PsA is a life-long condition that requires long-term treatment and a healthy lifestyle to minimize the impact of symptoms on your daily life. Progression of PsA is not necessarily inevitable.9 Diligent management can help improve your symptoms so that you can maintain a high quality of life over time.  

 

References

  1. Karmacharya P, Wright K, Achenbach SJ, et al. Time to transition from psoriasis to psoriatic arthritis: A population-based study. Semin Arthritis Rheum. 2022;52:151949. doi:10.1016/j.semarthrit.2021.12.013
  2. McLaughlin M, Ostör A. Early treatment of psoriatic arthritis improves prognosis. Practitioner. 2014;258(1777):21-3.
  3. Ocampo D V, Gladman D. Psoriatic arthritis. F1000Res. 2019;8:F1000 Faculty Rev-1665. Published 2019 Sep 20. doi:10.12688/f1000research.19144.1
  4. Fragoulis GE, Nikiphorou E, McInnes IB, Siebert S. Does Age Matter in Psoriatic Arthritis? A Narrative Review [published online ahead of print, 2021 Aug 15]. J Rheumatol. 2021;jrheum.210349. doi:10.3899/jrheum.210349
  5. Liu JT, Yeh HM, Liu SY, Chen KT. Psoriatic arthritis: Epidemiology, diagnosis, and treatment. World J Orthop. 2014;5(4):537-543. Published 2014 Sep 18. doi:10.5312/wjo.v5.i4.537
  6. Costa L, Perricone C, Chimenti MS, et al. Switching Between Biological Treatments in Psoriatic Arthritis: A Review of the Evidence. Drugs R D. 2017;17(4):509-522. doi:10.1007/s40268-017-0215-7
  7. Kessler J, Chouk M, Ruban T, Prati C, Wendling D, Verhoeven F. Psoriatic arthritis and physical activity: a systematic review. Clin Rheumatol. 2021;40(11):4379-4389. doi:10.1007/s10067-021-05739-y
  8. Perrotta FM, Scriffignano S, Benfaremo D, Ronga M, Luchetti MM, Lubrano E. New Insights in Physical Therapy and Rehabilitation in Psoriatic Arthritis: A Review. Rheumatol Ther. 2021;8(2):639-649. doi:10.1007/s40744-021-00298-9
  9. Dures E, Hewlett S, Lord J, et al. Important Treatment Outcomes for Patients with Psoriatic Arthritis: A Multisite Qualitative Study [published correction appears in Patient. 2019 Mar 23;:]. Patient. 2017;10(4):455-462. doi:10.1007/s40271-017-0221-4

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