The impact of age on activity index and patient reportedoutcomes in patients with Sjogren’s syndrome

Abstract

Sicca symptoms, such as xerostomia and xerophthalmia, are prevalent in geriatric patients and are correlated toexhaustion and low quality of life. Sjögren’s syndrome (SS), an autoimmune disorder characterized by lymphocyticinfiltration of the exocrine glands, also exhibits xerostomia and xerophthalmia as a main feature. In clinical practice,tools exist to assess disease activity and severity of the symptoms of Sjögren’s: the EULAR Sjögren’s SyndromeDisease Activity Index (ESSDAI) and the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), respectively.Our objective is to assess the disease activity and complaints in a cohort of Sicca syndrome patients, with anemphasis on senior individuals in particular. A cross-sectional investigation of 45 adult patients with a clinicaldiagnosis of Sicca syndrome was conducted, comparing geriatric (>65 years old;n= 23) vs. non-geriatric (n= 22)subgroups with respect to demographic and clinical data, classification criteria fulfillment, disease activity, andsymptom burden. Between the two age groups, no statistically significant differences were found regarding diseaseduration, immunological and histological features, or disease activity, with overall low ESSDAI values. Symptomburden was relevant, expressed by high ESSPRI values. Drugs that could worsen Sicca symptoms were frequentlyprescribed, mainly antidepressants. Symptom burden is significant in our cohort of SS patients. Unexpectedly,ESSPRI values were similar in both groups, despite the higher expected prevalence of Sicca complaints in ageriatric population. Even in people with mild illnesses, management of symptoms may be challenging and specialattention is needed in the geriatric population.