scholarly journals Clinical and Imaging Features of Novel Coronavirus Pneumonia in the Elderly Compared with Young and Middle-Aged Individuals

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Jia Cao ◽  
Jun Zhou ◽  
Qingyun Long ◽  
Gonghao Ling ◽  
Xingnan Liao
Keyword(s):  
Nucleic Acid ◽  
Elderly Patients ◽  
Clinical Features ◽  
Young Patients ◽  
The Elderly ◽  
Ct Imaging ◽  
Imaging Features ◽  
Age Related ◽  
Imaging Characteristics ◽  
Novel Coronavirus

Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported worldwide, but there are few reports on age-related computed tomography (CT) signs and clinical characteristics of COVID-19 patients. Objectives: We aimed to analyze the CT imaging characteristics and clinical features of elderly patients with novel COVID-19 and compare them with young COVID-19 patients, in order to provide imaging basis for clinical diagnosis. Patients and Methods: The clinical and chest CT imaging data of elderly patients (≥ 60 years) and young patients (age of 20 - 60 years) with positive novel coronavirus nucleic acid admitted to our hospital from January 28, 2020 to February 16, 2020 were retrospectively analyzed, and the differences in clinical and imaging characteristics between the two groups were compared. Results: One hundred eighty three COVID-19 patients (96 elderly: mean age, 72.76 ± 5.65; 87 young: mean age, 42.69 ± 12.44) with positive novel coronavirus nucleic acid were retrospectively enrolled. The clinical symptoms of fever (79%), cough (64%) and weakness (59%) in elderly patients were higher than those of young patients (P < 0.01). Asymptomatic young patients (15%) were more common than the elderly (2%) (P < 0.01). Twenty-four patients (13%) had lesions that involved both the periphery and the center of the lung, while the lesions were located in the periphery of the lung in 159 patients (87%). Ground-glass opacification in young patients (71%) was significantly higher than that of the elderly (26%) (P < 0.001). Compared with the young group (37%), the proportion of extensive involvement of lung lobes was higher in the elderly group (72%) (P < 0.001). Conclusion: Elderly and young patients with corona virus disease had some common CT and clinical features, but elderly patients may have relatively severe CT findings, and these differences may be related to the severity and prognosis of COVID-19 pneumonia.

scholarly journals CT Imaging Features During Disease Progression of 2019 Novel Coronavirus (COVID-19) Pneumonia

2020 ◽  
Vol 17 (4) ◽  
Author(s):  
Nan Yu ◽  
Yong Yu ◽  
Shubo Cai ◽  
Cong Shen ◽  
Youmin Guo
Keyword(s):  
Disease Progression ◽  
Symptom Onset ◽  
Early Stage ◽  
Ground Glass Opacity ◽  
Ct Imaging ◽  
Imaging Features ◽  
Imaging Characteristics ◽  
Novel Coronavirus ◽  
Stage 1

Objectives: To describe the characteristics of computed tomography (CT) in patients with 2019 novel coronavirus (COVID-19) pneumonia and their changes during disease progression. Patients and Methods: A total of 96 chest CT scans of 61 pneumonia patients associated with COVID-19 were reviewed to identify CT features associated with the time of symptom onset and the evolution of disease. Results: The initial CTs of 61 patients were obtained during 1 to 11 days after the onset. The main CT pattern of initial CT obtained during 1 - 3 days after the symptom onset was single (7/23, 35%) or multiple ground-glass opacity (GGO, 8/23, 35%). At 4 - 7 days after the symptom onset, the main imaging features were crazy paving GGO mixed with partial consolidation pattern (15/32, 47%). At 8 - 11 days after the symptom onset, the CT images showed consolidation pattern (3/6, 50%). A total of 35 follow up CTs were collected. The mean interval time between each follow up CT was 3 ± 2 days. The CT patterns also changed with the evolution of the disease: the features of GGO manifested at the early stage (1 - 3d). The crazy paving GGO pattern, consolidation pattern and mixed with partial consolidation pattern were found 4 to 14 days after the onset. In the absorption stage (15 - 24d), both density and extent of lesions were reduced. Conclusion: The CT imaging features are associated with the time of symptom onset and evolution of disease. Understanding the imaging characteristics of each stage is very helpful for understanding the development of disease.

scholarly journals Clinical Features and Prognostic Factors of Elderly Individuals with Retroperitoneal Liposarcoma

2021 ◽  
Author(s):  
Shuai Jin ◽  
Lianyuan Tao ◽  
Haibo Yu
Keyword(s):  
Prognostic Factors ◽  
Elderly Patients ◽  
Clinical Features ◽  
Young Patients ◽  
Staging System ◽  
The Elderly ◽  
Young Group ◽  
Retroperitoneal Liposarcoma ◽  
Ajcc Staging System ◽  
Ajcc Staging

Abstract Background: This study attempted to evaluate the clinical features and prognostic factors of elderly patients with retroperitoneal liposarcoma (RLS) and establish a nomogram to predict overall survival (OS). Methods: Patients diagnosed with RLS from 2010 to 2015 were identified from the Surveillance Epidemiology and End Results database. Clinical features and prognostic factors were examined, and a nomogram was constructed. Results: There were many differences between the elderly patients with RLS and the young patients with RLS; these differences included marital status, surgery, radiation, chemotherapy, and OS (P<0.05). An analysis of prognostic factors showed that surgery, as the main treatment for elderly patients, can significantly improve prognosis. Histological type and AJCC stage also had a significant effect on OS. Unlike the young group, age was an independent prognostic factor for the elderly. Nomograms for the elderly population were developed based on these prognostic factors. The C-indexes of the 1-, 3- and 5-year survival nomograms were 0.737 (95% CI 0.692-0.782), 0.737 (0.692-0.782) and 0.7367 (0.692-0.782), and the AUCs at 1, 3, and 5 years were 0.749, 0.804 and 0.810, respectively. Further results demonstrate the superiority of this approach in risk stratification over the AJCC staging system. Conclusions: Elderly patients with RLS are a particular group of individuals who are distinct from young patients in many clinical characteristics, and the constructed nomograms could accurately predict OS in elderly patients with RLS.

scholarly journals Age-Related Differences in Molecular Profiles for Immune Checkpoint Blockade Therapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Qi-jie Zhang ◽  
Jiao-chen Luan ◽  
Le-bin Song ◽  
Rong Cong ◽  
Cheng-jian Ji ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Immune Checkpoint ◽  
Treatment Efficacy ◽  
Young Patients ◽  
The Elderly ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Age Related ◽  
Cancer Types ◽  
Molecular Profiles

Immune checkpoint blockade (ICB) therapies have significantly improved the prognosis and shown considerable promise for cancer therapy; however, differences in ICB treatment efficacy between the elderly and young are unknown. We analyzed the studies enrolled in the meta-analysis using the deft approach, and found no difference in efficacy except melanoma patients receiving anti–PD-1 therapy. Similarly, higher treatment response rate and more favorable prognosis were observed in elderly patients in some cancer types (e.g., melanoma) with data from published ICB treatment clinical trials. In addition, we comprehensively compared immunotherapy-related molecular profiles between elderly and young patients from public trials and The Cancer Genome Atlas (TCGA), and validated these findings in several independent datasets. We discovered a divergent age-biased immune profiling, including the properties of tumors (e.g., tumor mutation load) and immune features (e.g., immune cells), in a pancancer setting across 27 cancer types. We believe that ICB treatment efficacy might vary depending on specific cancer types and be determined by both the tumor internal features and external immune microenvironment. Considering the high mutational properties in elderly patients in many cancer types, modulating immune function could be beneficial to immunotherapy in the elderly, which requires further investigation.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

scholarly journals Perioperative Multimodal Anesthesia Using Regional Techniques in the Aging Surgical Patient

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Diana Nordquist ◽  
Thomas M. Halaszynski
Keyword(s):  
Drug Therapy ◽  
Adverse Effects ◽  
Elderly Patients ◽  
Regional Anesthesia ◽  
Pain Control ◽  
The Elderly ◽  
Surgical Patient ◽  
Cochrane Central Register ◽  
Promising Alternative ◽  
Age Related

Background. Elderly patients have unique age-related comorbidities that may lead to an increase in postoperative complications involving neurological, pulmonary, cardiac, and endocrine systems. There has been an increase in the number of elderly patients undergoing surgery as this portion of the population is increasing in numbers. Despite advances in perioperative anesthesia and analgesia along with improved delivery systems, monotherapy with opioids continues to be the mainstay for treatment of postop pain. Reliance on only opioids can oftentimes lead to inadequate pain control or increase in the incidence of adverse events. Multimodal analgesia incorporating regional anesthesia is a promising alternative that may reduce needs for high doses and dependence on opioids along with any potential associated adverse effects. Methods. The following databases were searched for relevant published trials: Cochrane Central Register of Controlled Trials and PubMed. Textbooks and meeting supplements were also utilized. The authors assessed trial quality and extracted data. Conclusions. Multimodal drug therapy and perioperative regional techniques can be very effective to perioperative pain management in the elderly. Regional anesthesia as part of multimodal perioperative treatment can often reduce postoperative neurological, pulmonary, cardiac, and endocrine complications. Regional anesthesia/analgesia has not been proven to improve long-term morbidity but does benefit immediate postoperative pain control. In addition, multimodal drug therapy utilizes a variety of nonopioid analgesic medications in order to minimize dosages and adverse effects from opioids while maximizing analgesic effect and benefit.

Abstract P329: White Matter Score Does Not Predict Post-tPA Hemorrhage in Elderly Patients Evaluated Acutely via Telestroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad Bilal Tariq ◽  
Shekhar Khanpara ◽  
Eliana Bonfante Mejia ◽  
Liang Zhu ◽  
Christy T Ankrom ◽  
...  
Keyword(s):  
White Matter ◽  
Elderly Patients ◽  
The Elderly ◽  
Periventricular White Matter ◽  
Severe Stroke ◽  
Age Related ◽  
Increased Risk ◽  
Symptomatic Intracranial Hemorrhage ◽  
Relationship Of ◽  
Patient Presentation

Background: While tPA may be safe in the elderly, increasing age appears to augment risk of post-tPA symptomatic intracranial hemorrhage (sICH). Age-related white matter changes (ARWMC) are associated with increased sICH. Patients evaluated for acute ischemic stroke (AIS) via telestroke (TS) may not have access to MRI to allow incorporation of microbleeds in tPA decisions. We assessed if increased CT-based ARWMC was associated with increased sICH in elderly patients. Methods: Patients 80 years and older who received tPA for AIS at spoke hospitals were selected from our TS network registry from 9/2015 to 12/2018. TS spoke CT scans from patient presentation were reviewed by three of the authors for periventricular white matter (PWMC) and deep white matter (DWMC) changes. Total ARWMC score, based on the Fazekas score, was collected. Total ARWMC score was either mild (0-2), moderate (3-4), or severe (5-6). PWMC and DWMC were either mild (0-1) or moderate-severe (2-3). Logistic regression adjusted for age, sex, race, ethnicity, NIHSS and premorbid mRS was used to analyze relationship of ARWMC scores with sICH and patient-outcomes. Results: Of 241 patients, median age overall was 86 years (IQR 83-90), and 66% were female. The overall median ARWMC score was 3 (IQR 2-5). Regression analysis showed that more severe ARWMC scores did not lead to higher frequency of post-tPA ICH (moderate OR 0.57, CI 0.19-1.71; severe OR 1.32, CI 0.48-3.65) including sICH (moderate OR 0.78, CI 0.21-2.94; severe OR 2.09, CI 0.62-7.02). Similarly, severe PWMC and DWMC were not associated with increased risk of post-tPA ICH (PWMC OR 1.31, CI 0.51-3.38; DWMC OR 1.25, CI 0.52-3.01), including sICH (PWMC OR 1.61, CI 0.51-5.08; DWMC OR 1.81, CI 0.65-5.01). In our cohort, older patients had no difference in hemorrhage (ICH OR 0.93 CI 0.85-1.00: sICH OR 0.95 CI 0.86-1.04), and patients with less severe stroke were more likely to have hemorrhage (ICH OR 1.06 CI 1.02-1.10; sICH OR 1.08 CI 1.03-1.13). IRR among the CT scan readers was moderate (k=0.504). Conclusions: ARWMC scores were not associated with post-tPA ICH in the elderly. Our analysis lends support for the use of tPA despite severity of white matter disease. ARWMC should not be used to assist in tPA decision-making in elderly patients via telestroke.

Optimizing Antiepileptic Drug Therapy in the Elderly

2005 ◽  
Vol 39 (11) ◽  
pp. 1852-1860 ◽  
Author(s):  
William R Garnett
Keyword(s):  
Drug Therapy ◽  
Elderly Patients ◽  
Antiepileptic Drug ◽  
Age Groups ◽  
The Elderly ◽  
Complex Partial Seizures ◽  
Medline Search ◽  
Age Related ◽  
Epilepsy In The Elderly ◽  
Clonic Seizures

OBJECTIVE To review and evaluate the medical literature concerning antiepileptic drug (AED) therapy in elderly patients. DATA SOURCES A MEDLINE search (1982–December 2004) was conducted. Bibliographies of the articles identified were also reviewed, and an Internet search engine was used to identify additional pertinent references. STUDY SELECTION AND DATA EXTRACTION Clinical studies and reviews were evaluated, and relevant information was included. DATA SYNTHESIS The elderly have the highest incidence of seizures among all age groups. Complex partial seizures are the most common, followed by primary generalized tonic–clonic seizures. An accurate diagnosis may prove difficult because of a low suspicion of epilepsy in the elderly and other diseases that may mimic seizures. Most AEDs are approved for treatment of elderly patients who have partial and tonic–clonic seizures. However, a number of age-related variables should be addressed when selecting an appropriate AED. Age-dependent differences in pharmacokinetics and pharmacodynamics of AEDs must be taken into account. Drug–drug interactions must be considered since elderly people often take multiple medications. The ultimate factor that often determines AED selection is tolerability. CONCLUSIONS Numerous factors must be considered in treating elderly patients for seizures, but maximizing the ability of patients to tolerate drug therapy is often the basis for AED selection. Special consideration should be made along several lines, including elderly patients’ cognitive functioning and their tendency to respond to lower AED concentrations.

scholarly journals Confirmed or unconfirmed cases of 2019 novel coronavirus pneumonia in Italian patients: a retrospective analysis of clinical features

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Giulia De Angelis ◽  
Brunella Posteraro ◽  
Federico Biscetti ◽  
Gianluca Ianiro ◽  
Lorenzo Zileri Dal Verme ◽  
...  
Keyword(s):  
Clinical Features ◽  
Multivariable Analysis ◽  
Etiologic Agent ◽  
Nasopharyngeal Swab ◽  
Imaging Features ◽  
Rt Pcr ◽  
Rna Detection ◽  
Incubation Periods ◽  
Novel Coronavirus ◽  
To Receive

Abstract Background Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia. Methods On March 31, 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples. Results Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for 2 days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58–78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11–1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72–0.90; P < 0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P < 0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis. Conclusions Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.

Age-Related Variances in Patients with Tibial Plateau Fractures

2019 ◽  
Vol 33 (06) ◽  
pp. 611-615 ◽  
Author(s):  
Lasun O. Oladeji ◽  
John R. Worley ◽  
Brett D. Crist
Keyword(s):  
Elderly Patients ◽  
Tibial Plateau ◽  
Tibial Plateau Fracture ◽  
The Elderly ◽  
Tibial Plateau Fractures ◽  
Mechanism Of Injury ◽  
Younger Patients ◽  
Age Related ◽  
Comorbidity Burden ◽  
Plateau Fracture

AbstractTibial plateau fractures account for approximately 8% of fractures in the elderly population. Treatment strategies in the elderly are similar to those for younger patients; however, practitioners must account for the elevated comorbidity burden in this population. To date, few studies have analyzed age-based outcomes in patients with tibial plateau fractures. Therefore, the purpose of this study was to determine age-related variances in demographics, fracture characteristics, mechanism of injury, and complications. A 10-year retrospective review was conducted to identify patients who received treatment for a tibial plateau fracture. There were 351 patients (360 tibial plateau fractures) who were identified and subsequently stratified according to their age at the time of injury. Patients were classified as elderly if they were 65 years of age or older at the time of injury; all other patients were included in the control cohort. These two cohorts were analyzed using bivariate analysis to isolate for age-related variations with respect to risk factors, mechanism of injury, and complications. There were 351 patients (360 tibial plateau fractures) with a median follow-up of 1.84 ± 2.44 years who met inclusion criteria. There were a greater proportion of women in the elderly cohort as compared with the younger cohort (60.0 vs. 43.4%, p = 0.06). Elderly patients were significantly more likely to present with diabetes (33.3 vs. 16.1%, p = 0.01) or osteoporosis (14.3 vs. 1.6%, p = 0.001). Younger patients were significantly more likely to require further surgery to address ligament (12.6 vs. 0%, p = 0.008), meniscus (20.9 vs. 7.1%, p = 0.036), or cartilage pathology (13.6 vs. 0%, p = 0.005). There was no difference in the arthroplasty conversion rate (4.8% elderly vs. 7.9% control, p = 0.755). While elderly patients presented with a greater comorbidity burden, they had equivalent or better short-term outcomes when compared with their younger peers when treated with open reduction and internal fixation (ORIF). Despite the recent interest in primary total knee arthroplasty for elderly patients with tibial plateau fractures, the results of this study suggest that elderly patients may respond well when treated with ORIF following a tibial plateau fracture.

Rheumatologists’ Views and Experiences in Managing Rheumatoid Arthritis in Elderly Patients: A Qualitative Study

2018 ◽  
Vol 45 (5) ◽  
pp. 590-594 ◽  
Author(s):  
Jill Nawrot ◽  
Annelies Boonen ◽  
Ralph Peeters ◽  
Mirian Starmans ◽  
Marloes van Onna
Keyword(s):  
Qualitative Study ◽  
Elderly Patients ◽  
Disease Activity ◽  
Management Strategies ◽  
The Elderly ◽  
Treat To Target ◽  
Management Approach ◽  
Semistructured Interview ◽  
Das28 Score ◽  
Age Related

Objective.In this qualitative study we analyzed the (1) influence of age, comorbidity, and frailty on management goals in elderly patients with RA; (2) experiences of rheumatologists regarding the use of the Disease Activity Score at 28 joints (DAS28) to monitor disease activity; and (3) differences in management strategies in elderly patients with RA compared to their younger counterparts.Methods.Rheumatologists were purposively sampled for a semistructured interview. Two readers independently read and coded the interview transcripts. Important concepts were taxonomically categorized and combined in overarching themes by using NVivo 11 software.Results.Seventeen rheumatologists (mean age 44.8 yrs, SD 7.7 yrs; 29% male) from 9 medical centers were interviewed. Preserving an acceptable level of functioning was the most important management goal in patients ≥ 80 years and in patients with high levels of comorbidity and frailty. The DAS28 score less frequently steered the management strategy, because rheumatologists commented that comorbidity and an age-related erythrocyte sedimentation rate elevation might distort the DAS28 score. Instead, management of elderly patients highly depended on comorbidity, frailty, and their subsequent effects such as cognitive and physical decline, dependency, and polypharmacy. Presence of 1 or more of these factors frequently resulted in a less future-oriented management approach with less emphasis on the maximal prevention of joint erosions.Conclusion.The treat-to-target model is not automatically adopted in the elderly patient population. Future evidence-based RA management recommendations for elderly patients with RA are needed and should account for factors such as comorbidity and frailty.

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