Drugs & Aging

, Volume 25, Issue 1, pp 19–33 | Cite as

Sjögren’s Syndrome

Diagnosis and Therapeutic Challenges in the Elderly
  • Kristine P. Ng
  • David A. Isenberg
Therapy In Practice


Sjögren’s syndrome (SS) is a chronic autoimmune rheumatic disease characterized by keratoconjunctivitis sicca and xerostomia as a result of lymphocytic infiltration of the lacrimal and salivary glands. Extra-glandular manifestations occur in about one-third of patients with SS. The diagnosis of SS in the geriatric population is not straightforward and consideration needs to be given to exclusion of other conditions that may have similar presenting symptoms. The presence of autoantibodies, in particular anti-Ro and anti-La antibodies, may aid in the diagnosis of SS. Salivary gland biopsy findings represent one of the objective criteria included in the widely accepted American-European classification diagnostic criteria. However, SS-like histological changes can also be present in the healthy elderly, adding to the dilemma in diagnosing this condition in the geriatric population. Management of SS involves local treatment of dry eyes and mouth with replacement and stimulation therapies. Patients with more serious systemic involvement may require immunosuppressive therapy. Medications that are routinely used in the treatment of patients with SS often have limited use in the elderly population because patients in the latter group may have complex comorbid conditions and be taking multiple medications. Recently, use of newer targeted therapies has been explored in SS. This article provides an update on recent developments in the diagnosis and management of SS, with emphasis on issues that may arise when treating elderly patients with this condition.


Salivary Gland Keratoconjunctivitis Sicca Sicca Symptom Cevimeline Minor Salivary Gland Biopsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this article. Dr Kristine P. Ng is a recipient of the New Zealand Rose Hellaby medical scholarship.

The authors have no conflicts of interest that are directly relevant to the content of this article.


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© Adis Data Information BV 2008

Authors and Affiliations

  1. 1.Centre for Rheumatology Research, Division of MedicineUniversity College LondonLondonUK

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