[Gerontorheumatology. Aspects of diagnosis, course and therapy of inflammatory rheumatic disease in advanced age].

Gerontorheumatology deals with the particular features of onset, course and treatment of rheumatic diseases in patients of advanced age. The initial diagnosis of inflammatory rheumatic disease after the age of 60 is hindered by the frequency of non-specific general disease symptoms. The most important gerontorheumatological diseases include rheumatoid arthritis first occurring at advanced age ("late onset rheumatoid arthritis", LORA), rheumatic polymyalgia and giant cell arteritis. Important differential diagnoses in older rheumatology patients are RS3PE syndrome, polyarticular chondrocalcinosis and paraneoplastic rheumatic syndrome. In principle, all specific basic therapeutics, immunosuppressants and biologics can be used for the therapy of these diseases. However, careful dose selection is particularly necessary in the initial phase, taking age-specific limitations in organ function and metabolism into consideration; moreover, close-meshed tolerance tests should be carried out.