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Älter werden mit axialer Spondyloarthritis

Becoming older with axial spondyloarthritis

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Zusammenfassung

Die physiologischen Altersveränderungen wie Verlust von Muskelmasse und -funktion, Reduzierung von Organfunktionen und degenerative Gelenkveränderungen treffen bei Patienten mit ankylosierender Spondylitis (AS) auf krankheitsspezifische Veränderungen, die ältere AS-Patienten vulnerabel für andere Erkrankungen machen. Verschiedene Prozesse führen bei solchen Patienten zu einer reduzierten körperlichen Funktionsfähigkeit, zu einer veränderten Körperhaltung, zu verminderter Knochendichte und Sarkopenie, was zu vermehrter Fallneigung und Wirbelkörperfrakturen führen kann. Die Mortalität ist bei Patienten mit AS v. a. bei Männern insbesondere aufgrund der erhöhten kardiovaskulären Mortalität erhöht. Die standardisierte Erfassung kardiovaskulärer Risikofaktoren bei Patienten mit entzündlich rheumatischen Erkrankungen wird zwar seit Jahren empfohlen (unabhängig vom Alter der Patienten), dies wird jedoch kaum umgesetzt. Insgesamt liegen hinsichtlich Komorbiditäten und Risikofaktoren fast ausschließlich Untersuchungen bei AS-Patienten und nicht anderen Spondyloarthritiden vor.

Abstract

The combination of physiological age-related changes (e. g. reduction in muscle mass and function, reduction in organ function and degenerative changes in joints) and disease-specific changes of ankylosing spondylitis (AS), make older AS patients vulnerable for additional diseases. In this patient population various processes lead to a reduction in physical function, changes in posture, osteoporosis and sarcopenia, which then can result in falls and fractures, especially vertebral fractures. Mortality is increased in patients with AS, particularly in men due to an increase in cardiovascular mortality. Although the standardized assessment of cardiovascular risk factors in patients with inflammatory rheumatic diseases (independent of age) has been recommended for years, it is rarely done in clinical practice. Overall, data on comorbidities and risk factors are only available for AS patients and are lacking for other forms of spondyloarthritides.

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Correspondence to U. Kiltz.

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U. Kiltz, X. Baraliakos, B. Buehring und J. Braun geben an, dass kein Interessenkonflikt besteht.

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E. Märker-Hermann, Wiesbaden

H.-J. Lakomek, Minden

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Kiltz, U., Baraliakos, X., Buehring, B. et al. Älter werden mit axialer Spondyloarthritis. Z Rheumatol 77, 363–368 (2018). https://doi.org/10.1007/s00393-018-0446-1

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