Arthritis in the elderly

In old age, particularly in those over the age of 75 years, the disease process is operating in a unique setting. The awareness of this uniqueness has been slow in coming to the attention of the medical profession but the weight of clinical experience imposed by demographic change in the population has made this an urgent consideration. Arthritis presents in a setting where there are multiple ageing or degenerative features and it occurs frequently in conjunction with other diseases. Early and accurate diagnosis is of paramount importance in the elderly because of the many interacting factors and the fragile 'milieu interieur'. Judicious use of drugs with close monitoring is essential if the patients's well being is to be improved and the morbidity reduced. Joint disease, osteoarthritis and rheumatoid arthritis make a significant contribution to disability and dependence in the elderly and have certain features which are more common than those found in the younger age groups.