Those with systemic lupus erythematosus, or lupus, know it is a life-long illness. What many do not know is how the disease will treat them as they grow older. Here are five facts associated with lupus and age.
Symptom activity tends to improve with age
As a person ages, lupus activity –- or the degree of inflammation and auto-immunity present –- typically declines. This may lead to adjustments in treatment (including a reduction in medication).
On the flip side, severity of the disease can increase, which means the sum of your disease activity in the past, including the damage it has caused. This could lead to physical therapy, joint replacements or other non-pharmacological treatments as you age.
Osteoporosis is common in patients with lupus
Individuals with lupus are at increased risk for osteoporosis. Here’s why:
- Certain treatments for lupus, such as glucocorticoid medications (Prednisone), which can cause bone loss
- A more sedentary lifestyle due to pain caused by lupus, which can increase osteoporosis risk
- A possible link between lupus and bone loss in general
Furthermore, studies suggest an increase in bone loss and fracture in individuals with lupus. In fact, women with lupus may be five times more likely to experience a fracture from osteoporosis.
One must also consider that weight, genetics, and whether one smokes also contribute to early bone loss.
Lupus patients can undergo short courses of hormone replacement therapy (HRT)
Though there is a small risk for increasing the flare rate for those with lupus, the benefits of a short course of HRT need to be seriously weighed. Most flares associated with HRT are considered mild to moderate and there is no significant risk for severe flare, but there also is major concern over increased risk of cardiovascular disease (for which lupus patients are already at markedly increased risk) and in some lupus patients (those with anti-phospholipid antibody syndrome), serious and life-threatening blood clots.
Older patients are less likely to suffer from kidney disease associated with lupus
Studies show that older patients are less likely to suffer from kidney diseases associated with lupus (lupus nephritis, but there are no strong conclusions as to why. For those that do encounter kidney issues, at any age, treatment is the same.
Lupus can go into remission –- at any age.
While many believe lupus can disappear in later age, remission can occur at any age, and usually does so with treatment.
Sources: Chat Transcript for Dr. Ronenn Roubenoff. Lupus Foundation of America. November 14, 2007
Conditions and Behaviors that Increase Osteoporosis Risk. The National Institutes of Health and the U.S. Department of Health and Human Services. November 2006.
