Xerostomia secondary to Sjögren's syndrome in the elderly recognition and management

Ibtisam Al-Hashimi

Research output: Contribution to journalReview article

32 Citations (Scopus)

Abstract

Xerostomia is a common symptom in the elderly population. Studies have suggested that the underlying cause of approximately 40% of xerostomia in the elderly is Sjögren's syndrome. Although it is highly prevalent among middle-aged individuals, elderly patients account for up to 20% of Sjögren's syndrome cases. Sjögren's syndrome is a multisystem exocrinopathy characterised by dry mouth and dry eyes with wide-ranging extraglandular involvement. The exocrine manifestations of Sjögren's syndrome affect the mouth, eyes, nose, ears, skin, vagina and the entire respiratory and gastrointestinal systems. The nonexocrine involvement may include the joints, thyroid gland, liver, kidneys and the musculoskeletal, vascular and central nervous systems. Currently, the mechanism(s) of development and progression of Sjögren's syndrome is/are not clear. Inflammation and lymphocytic infiltration of the exocrine glands is a classical feature of Sjögren's syndrome. During the progression of the disease, the acinar cells of the exocrine glands are replaced by fibrosis, rendering the glands nonfunctional. Sjögren's syndrome remains one of the most underdiagnosed conditions, particularly in the elderly population, because the cardinal sicca symptoms, which are the hallmark of the disease, are frequently attributed to aging and/or medications, which consequently delays the diagnosis. This delay in diagnosis imposes significant physical, psychological and economic burdens on elderly patients. The diagnosis of Sjögren's syndrome requires evaluation of both the exocrine and nonexocrine components of the disease. Management of Sjögren's syndrome requires collaboration by the primary-care physician, rheumatologist, ophthalmologist and dentist. This article reviews current understanding of the clinical manifestations, diagnosis and treatment of Sjögren's syndrome with special emphasis on the oral component of the disease.

Original languageEnglish (US)
Pages (from-to)887-899
Number of pages13
JournalDrugs and Aging
Volume22
Issue number11
DOIs
StatePublished - Dec 13 2005

Fingerprint

Xerostomia
Exocrine Glands
Mouth
Mouth Diseases
Acinar Cells
Primary Care Physicians
Vagina
Dentists
Nose
Respiratory System
Population
Ear
Blood Vessels
Disease Progression
Thyroid Gland
Fibrosis
Central Nervous System
Joints
Economics
Psychology

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Pharmacology

Cite this

Xerostomia secondary to Sjögren's syndrome in the elderly recognition and management. / Al-Hashimi, Ibtisam.

In: Drugs and Aging, Vol. 22, No. 11, 13.12.2005, p. 887-899.

Research output: Contribution to journalReview article

Al-Hashimi, Ibtisam. / Xerostomia secondary to Sjögren's syndrome in the elderly recognition and management. In: Drugs and Aging. 2005 ; Vol. 22, No. 11. pp. 887-899.
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abstract = "Xerostomia is a common symptom in the elderly population. Studies have suggested that the underlying cause of approximately 40{\%} of xerostomia in the elderly is Sj{\"o}gren's syndrome. Although it is highly prevalent among middle-aged individuals, elderly patients account for up to 20{\%} of Sj{\"o}gren's syndrome cases. Sj{\"o}gren's syndrome is a multisystem exocrinopathy characterised by dry mouth and dry eyes with wide-ranging extraglandular involvement. The exocrine manifestations of Sj{\"o}gren's syndrome affect the mouth, eyes, nose, ears, skin, vagina and the entire respiratory and gastrointestinal systems. The nonexocrine involvement may include the joints, thyroid gland, liver, kidneys and the musculoskeletal, vascular and central nervous systems. Currently, the mechanism(s) of development and progression of Sj{\"o}gren's syndrome is/are not clear. Inflammation and lymphocytic infiltration of the exocrine glands is a classical feature of Sj{\"o}gren's syndrome. During the progression of the disease, the acinar cells of the exocrine glands are replaced by fibrosis, rendering the glands nonfunctional. Sj{\"o}gren's syndrome remains one of the most underdiagnosed conditions, particularly in the elderly population, because the cardinal sicca symptoms, which are the hallmark of the disease, are frequently attributed to aging and/or medications, which consequently delays the diagnosis. This delay in diagnosis imposes significant physical, psychological and economic burdens on elderly patients. The diagnosis of Sj{\"o}gren's syndrome requires evaluation of both the exocrine and nonexocrine components of the disease. Management of Sj{\"o}gren's syndrome requires collaboration by the primary-care physician, rheumatologist, ophthalmologist and dentist. This article reviews current understanding of the clinical manifestations, diagnosis and treatment of Sj{\"o}gren's syndrome with special emphasis on the oral component of the disease.",
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