The Burden of Arthritis on Quality of Life

In the July/August issue of Geriatrics & Aging, I wrote an editorial on falls in the elderly. Falls, of course, are part of the broader issue of mobility in the elderly, and nothing lowers the quality of life for older people as much as impaired mobility. In fact, more severe mobility restrictions (e.g., being housebound) are also correlated with decreased survival. The reasons for the association between aging and mobility impairment are very complex. In our last issue, the importance of fitness in maintaining mobility was stressed. Age- and disease-related changes in the neurological system also are important factors in decreased mobility, and neurological disease increases dramatically with advancing age. However, there is no doubt that arthritis is probably the most common reason for impaired mobility in the elderly. As I have noted in previous issues, arthritis is much more likely to impair quality of life than is angina. Often, older persons are less frightened by the issues of mortality than they are by the prospect of pain and disability.

This issue addresses problems seen in several of the common types of arthritis. Dr. Herbert von Schroeder outlines the surgical management of osteoarthritis of the hand and the wrist, Dr. Benjamin R. Davis reviews the management of temporomandibular disorders in older people, and Dr. Geoffrey F. Dervin discusses management of the arthritic knee. Oksana Davidovich gives an overview of the painful geriatric foot, a condition in which arthritis is an important, but not exclusive, factor. Our Drugs & Aging column focuses on the very expensive biologic treatments for inflammatory arthritis, and their possible role in older persons. Dr. Charles D. Ray writes about the diagnosis and treatment of lumbar spinal stenosis. I sometimes feel that this is an area in which our ability to image the problem is far advanced compared to our understanding of its clinical diagnosis and management.

We have a variety of other articles on offer as well. Dr. Alan K. Berger reviews the literature on reperfusion therapy for acute myocardial infarction while Jonathan Ship outlines the diagnosis and management of a common and often ignored issue in older people, xerostomia. Drs. Christina M. Canil and Jennifer J. Knox discuss the topic of renal cell cancer, and the relationship between statin use and dementia is reviewed by Dr. Milita Crisby.

Enjoy this issue.