Review of Late Onset Gout and Gouty Arthritis

Title: Gouty arthritis. A primer on late-onset gout.
Ene-Stroescu D, Gorbien MJ
Publications: Geriatrics. 2005 Jul;60(7):24-31.

Gouty arthritis is the most common form of inflammatory arthritis in older people. In this article, the authors reviewed the cause of hyperuricemia (excessively high levels of uric acid in the blood), gout, and clinical forms of gouty arthritis.

Gout can be present if the patients are obese, or have diabetes mellitus, hyperlipidemia (excess fats or lipids in the blood), and coronary artery disease. Therefore, patients should be counseled on gout if they have any of these conditions.

The authors reviewed general management of gout, and particularly significant clinical manifestation of gout including increased incidence in women, presence in multiple joints starting with those in the hand, earlier development of gouty deposits or tophi, and association with use of diuretics or medications that increase the discharge of urine.

The authors also presented barriers against optimal control of gout, such as lack of patient education, use of multiple drugs such as diuretics, decline in cognitive function, and presence of other medical conditions in addition to gout, particularly kidney problems. The authors then concluded that gout management in older adults remained unsatisfactory.

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