Disease and Treatment Characteristics in Geriatric Psoriasis: A Patient Survey Comparing Age Groups

Abstract

Little is known about geriatric psoriasis, although health problems and medication can complicate the management of psoriasis. To compare characteristics of patients ≥ 65 years old with those < 65 years old, a survey was sent to all members (3,310) of the Dutch Psoriasis Association. In total, 985 (29.7%) patients returned the survey, 414 (43.6%) respondents were ≥ 65 years old. Despite more comorbidities and medication use in ≥ 65 years old, no difference was seen between age groups regarding systemic antipsoriatic treatment (38.3% vs 42.3%). Side-effects were reported more frequently by patients < 65 years old. Thus, age alone should not limit psoriasis treatment, and proper attention must be paid to patient-related factors. Little is known about psoriasis in geriatric patients, whereas treating this growing population can be challenging due to comorbidities, comedication and physical impairments. To compare disease and treatment characteristics of psoriasis patients ≥ 65 years old with patients < 65 years old, a self-assessment survey was sent to all members of the Dutch Psoriasis Association (n = 3,310). In total, 985 (29.7%) patients returned the survey, 414 (43.6%) respondents were ≥ 65 years old. Patients ≥ 65 years old had experienced erythrodermic psoriasis significantly more frequently than patients < 65 years old, other disease characteristics were highly comparable. Despite a significantly higher prevalence of comorbidities and comedication use in patients ≥ 65 years old, no difference was seen between the age groups regarding systemic antipsoriatic treatment (38.3% in ≥ 65 years old vs 42.3% in < 65 years old; p = 0.219). Remarkably, treatment-related side-effects were reported more frequently by patients < 65 years old. In conclusion, age alone should not be a limiting factor in psoriasis management, and proper attention must be paid to additional patient-related factors.

Quality of life, treatment goals, preferences and satisfaction in older adults with psoriasis: a patient survey comparing age groups

“…Among the responses suitable for analysis ( n = 950; 28·7%), 414 (43·6%) patients were aged ≥ 65 years (mean age 72·4 ± 5·9 years). Disease severity was comparable between the groups 4 . Patients aged ≥ 65 years and those aged < 65 years reported pruritus as the most bothersome aspect of psoriasis [127 (35·0%) vs. 200 (39·8%), P = 0·146], followed by flaking [72 (19·8%) vs. 122 (24·3%), P = 0·120] and visibility [58 (16·0%) vs. 107 (21·3%), P = 0·049].…”

“…It should be taken into account that overall patient preferences in patients aged ≥ 65 years differed from those of patients aged < 65 years, particularly in relation to the reduction of medication use and hospital visits. Dependency on others could be an explanation for this outcome, 4 as functional impairments in this patient group can cause difficulty in reaching certain areas of the body. Therefore, patients aged ≥ 65 years might experience a higher treatment burden when using topical or subcutaneously administrated therapies.…”

“…Previous studies reported comparable disease severity in patients aged ≥ 65 years and patients aged < 65 years, [2][3][4] although prescribed antipsoriatic therapies differed between age groups. 2,3,5 This might be due to comorbidities and comedication, and/or disease perception or patient preferences.…”

“…Dear Editor , Psoriasis management in the rapidly expanding geriatric population can be complex owing to frailty, comorbidities, comedication and limited available data on treating older patients with psoriasis 1 . Previous studies reported comparable disease severity in patients aged ≥ 65 years and patients aged < 65 years, 2–4 although prescribed antipsoriatic therapies differed between age groups 2,3,5 . This might be due to comorbidities and comedication, and/or disease perception or patient preferences 3,5 .…”

“…The methodology of this study was described in a previous publication. 4 The Dermatology Life Quality Index (DLQI), 5-point Likert scales and open-ended questions were used to study disease burden, QoL impact, treatment goals, preferences and satisfaction. To adjust for 'not relevant' responses (NRRs), the DLQI-Relevant (DLQI-R) score was calculated, with a maximum of three NRRs per patient.…”