title: Characterization of fibromyalgia symptoms in patients 55-95 years old: a longitudinal study showing symptom persistence with suboptimal treatment.
abstract: BACKGROUND
  Fibromyalgia (FM) has been understudied in the elderly population, a group with particular vulnerabilities to pain, reduced mobility, and sleep disruption.
  
  
  OBJECTIVE
  To characterize FM symptoms and treatments in a cohort of older subjects examined over time to determine the extent to which current, community-based treatment for older FM patients is in accord with published guidelines, and effective in reducing symptoms.
  
  
  METHODS
  A longitudinal, observational study of 51 subjects with FM (range 55-95 years) and 81 control subjects (58-95 years) performed at Banner Sun Health Research Institute in Sun City, AZ, USA. Serial history and examination data were obtained over a 6-year period. FM data included medical history, medications, physical examination, tender point examination, neuropsychological testing, sleep and pain ratings, the Physical Function Subscale of the Fibromyalgia Impact Questionnaire, and other standardized scales to evaluate depression and other psychiatric symptoms, and cognitive and functional impairment.
  
  
  RESULTS
  Pain and stiffness that interfered with physical activity, sleep, and mood were reported by 80 % or more of subjects. Over time, pain involved an increasing number of body areas. Over half of subjects were treated with NSAIDs, one-quarter with opioids, and one-quarter with estrogen. Few were treated with dual-acting antidepressants or pregabalin.
  
  
  CONCLUSIONS
  In this cohort of elders with suboptimally treated FM, substantial persistence of symptoms was seen over time. In general, recommended treatments were either not used or not tolerated.
  
  
  CONCLUSIONS
  Age-appropriate treatments as well as education of primary care providers are needed to improve treatment of FM in the older population.
authors.affiliation: Banner Sun Health Research Institute, 10515 W Santa Fe Dr, Sun City, AZ, 85351, USA, Sandra.Jacobson@bannerhealth.com.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Jacobson
authors.forename: Rachel G
authors.initials: RG
authors.lastname: Simpson
authors.forename: Cheri
authors.initials: C
authors.lastname: Lubahn
authors.forename: Chengcheng
authors.initials: C
authors.lastname: Hu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Belden
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Davis
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Nicholson
authors.forename: Kathy E
authors.initials: KE
authors.lastname: Long
authors.forename: Tracy
authors.initials: T
authors.lastname: Osredkar
authors.forename: Dianne
authors.initials: D
authors.lastname: Lorton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003071:Cognition; D005260:Female; D005356:Fibromyalgia / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D000069583:Pregabalin / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000069583:Pregabalin