[Sjögren's syndrome in the elderly].

Area of Science:

• Immunology
• Rheumatology
• Geriatrics

Context:

• Sjögren's syndrome is an immune exocrinopathy primarily affecting salivary and lacrimal glands.
• Primary Sjögren's syndrome occurs independently of other rheumatologic conditions like polyarthritis or lupus erythematosus.
• Prevalence of Sjögren's syndrome is suggested to increase with age.

Purpose:

• To address the diagnostic challenges of primary Sjögren's syndrome in the elderly population.
• To review diagnostic criteria and testing specificities in older adults.
• To highlight key indicators for diagnosing Sjögren's syndrome in elderly patients.

Summary:

• The paper focuses on primary Sjögren's syndrome, an immune exocrinopathy characterized by salivary and ocular dryness.
• Diagnosis in the elderly is complicated as sicca symptoms are common and often iatrogenic.
• Current diagnostic criteria, such as the European criteria (1993, revised 1996), have limitations in individuals over 60.
• Tests like Schirmer's test and non-stimulated salivary flow lack specificity in this age group.
• The diagnostic value of lip salivary gland biopsy (focus score) is also discussed.
• The diagnosis should be considered when elderly patients present with sicca symptoms coupled with systemic manifestations.

Impact:

• Improves understanding of Sjögren's syndrome diagnosis in geriatric populations.
• Highlights the need for refined diagnostic approaches for immune exocrinopathies in the elderly.
• Emphasizes the importance of considering systemic involvement in the diagnosis of Sjögren's syndrome in older adults.