Abstract
Background
Fibromyalgia (FM) has been understudied in the elderly population, a group with particular vulnerabilities to pain, reduced mobility, and sleep disruption.
Aims
To characterize FM symptoms and treatments in a cohort of older subjects examined over time to determine the extent to which current, community-based treatment for older FM patients is in accord with published guidelines, and effective in reducing symptoms.
Methods
A longitudinal, observational study of 51 subjects with FM (range 55–95 years) and 81 control subjects (58–95 years) performed at Banner Sun Health Research Institute in Sun City, AZ, USA. Serial history and examination data were obtained over a 6-year period. FM data included medical history, medications, physical examination, tender point examination, neuropsychological testing, sleep and pain ratings, the Physical Function Subscale of the Fibromyalgia Impact Questionnaire, and other standardized scales to evaluate depression and other psychiatric symptoms, and cognitive and functional impairment.
Results
Pain and stiffness that interfered with physical activity, sleep, and mood were reported by 80 % or more of subjects. Over time, pain involved an increasing number of body areas. Over half of subjects were treated with NSAIDs, one-quarter with opioids, and one-quarter with estrogen. Few were treated with dual-acting antidepressants or pregabalin.
Discussion
In this cohort of elders with suboptimally treated FM, substantial persistence of symptoms was seen over time. In general, recommended treatments were either not used or not tolerated.
Conclusions
Age-appropriate treatments as well as education of primary care providers are needed to improve treatment of FM in the older population.
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Acknowledgments
The study team wishes to acknowledge Adele Ricken for assistance in scheduling and retention of subjects for this program, Janet Wies for assistance in coding and data entry, Dr. Robert M. Bennett for invaluable project consultation, and the late Dr. Raymond T. Mirise (1944–2009), who performed many of the initial rheumatologic evaluations for fibromyalgia in our cohort. The project was funded by NIAMS RO11AROS4647 Human Spinal Cord Glial Cytokines and Chronic Pain, and the American Fibromyalgia Syndrome Association OCG4584B, Dianne Lorton, Principal Investigator. The Brain and Body Donation Program is supported by the National Institute of Neurological Disorders and Stroke (U24 NS072026 National Brain and Tissue Resource for Parkinson’s Disease and Related Disorders), the National Institute on Aging (P30 AG19610 Arizona Alzheimer’s Disease Core Center), the Arizona Department of Health Services (contract 211002, Arizona Alzheimer’s Research Center), Arizona Biomedical Research Commission (contracts 4001, 011, 05-901 and 1001 to the Arizona Parkinson’s Disease Consortium), and the Michael J. Fox Foundation for Parkinson’s Research. The sponsors had no role in the design, methods, subject recruitment, data collection, or analysis for this project, or in preparation of the manuscript.
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Jacobson, S.A., Simpson, R.G., Lubahn, C. et al. Characterization of fibromyalgia symptoms in patients 55–95 years old: a longitudinal study showing symptom persistence with suboptimal treatment. Aging Clin Exp Res 27, 75–82 (2015). https://doi.org/10.1007/s40520-014-0238-7
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DOI: https://doi.org/10.1007/s40520-014-0238-7