Gout in the elderly

Gout, the most common of the crystal arthritides is a result of disturbed uric acid metabolism and precipitation of urate crystals in extra cellular space of joints, periarticular tissue, bones and other organs.

The frequencies of obesity, chronic kidney disease (CKD),hypertension, type 2 diabetes, dyslipidaemias, cardiac diseases (including coronary heart disease, heart failure and atrial fibrillation), stroke and peripheral arterial disease have been repeatedly shown to be increased in gout.

There is an increased incidence of gout in the elderly, with the clinical picture differing somewhat from middle age. Additionally, complications may be more severe. The management of gout may be more challenging in the elderly, due to medical co-morbidities, deteriorating metabolic function and drug interactions due to polypharmacy.

Older people with decreased kidney function, low albumin levels, or requiring diuretic and/or aspirin therapy, are at higher risk of developing gout.

In the West, gout affects around 1% of adult men over 45 years of age. The estimated incidence being 0.6 to 2.1 per 1000 per year, with a prevalence of 9.5 to 13.5 per 1000 persons of all ages.
Gout in the elderly

Macular degeneration

Macular degeneration also known as age-related macular degeneration (AMD or ARMD) is the most common cause of legal blindness in people over 50 in the United States. There is no medical treatment for dry AMD and no cure.

Macular degeneration is caused by cumulative damage to the macula, the center of the retina, where both ganglion cells and cones are present at very high densities. It starts as a blurred spot in the center of what you see. As the degeneration spreads, vision shrinks.

Free radicals generated by sunlight, cigarette smoke, air pollution, infection, and metabolism cause much of this damage.

In the past several years, researchers have found genes associated with Stargardt disease both wet and dry AMD and retinitis pigmentosa. May eye diseases, including retinitis pigmentosa, familial exultative maculopathy, Sticker’s syndrome, and stationery night blindness, have a genetic component.
Macular degeneration