Spotlight on Aging: Giant Cell Arteritis and Polymyalgia Rheumatica
Giant cell (temporal) arteritis and polymyalgia rheumatica, which often occur together, affect people over age 50 years almost exclusively. These disorders become more common as people age. Giant cell arteritis typically causes a throbbing headache and problems with vision (including pain in and around the eyes). Polymyalgia rheumatica makes muscles painful and stiff. Without treatment, the pain these disorders cause, whether they occur together or separately, can make everyday living miserably difficult. Also, without prompt treatment, giant cell arteritis can cause blindness. The main treatment of these disorders, corticosteroids, may be problematic in older adults. These medications can cause dramatic improvement and are essential for preventing blindness. However, they are more likely to have side effects in older adults. People may retain fluids, their appetite may increase, and they may become confused. Blood sugar may increase, sometimes causing diabetes, and bone density may decrease. Blood pressure may increase. To reduce the risk of these effects, doctors reduce the dose of the corticosteroid and stop the medication as soon as possible. Older adults who take corticosteroids are encouraged to take measures to help maintain bone density. They can do weight-bearing exercise and take . Taking antiresorptive medications can help increase bone density. Such medications include bisphosphonates Faithfully continuing treatment as instructed results in complete recovery for many people. |