Longevity for Rheumatologists

In recent years, I have become increasingly involved in the field of longevity medicine and the extension of healthspan. There is a paradigm shift from treatment towards prevention. Recently I delivered a lecture in Rome on this topic and have also been invited to speak at a conference in Miami next year, organised by Sciinov. 

The musculoskeletal system plays a fundamental role in maintaining healthspan and quality of life during ageing, underlining the important responsibilities of rheumatologists in preventive and longevity -focused medicine.

The world’s population is aging. The number of elderly people will double by the end of the 2050s, and the population of 65+ has already outnumbered those of 18-. The aging population is significantly more prone to illnesses, disability and mortality, all of which increase the burden on both society and healthcare systems.

I am a rheumatologist specialising in inflammatory rheumatic diseases of older age onset. This year, at the Global Longevity Conference, in Rome I have spoken of these elderly onset diseases and their medical treatment. In addition to  osteoarthritis, older age onset arthritides, including older age onset rheumatoid arthritis and late onset spondyloarthritis, polymyalgia rheumatica and the closely related giant cell arteritis have been also described. The elderly rheumatic patient generally presents co-morbidities and polypharmacy with multiple side effects often complicates treatment. Geriatric syndromes associate and roll up in the so-called „spaghetti model” of managing the aged multimorbid patient.

Musculoskeletal health is considered one of the core pillars of longevity. Osteopenia, sarcopenia and joint degeneration are well-known age-related syndromes; therefore, regular physical activity is also important in healthy elderly to prevent frailty and preserve physical and cognitive function. 

Polypharmacy and treatment-related adverse events are common challenges in elderly patients, increasing the importance of non-pharmacological therapeutic approaches.  Guidelines of World Physiotherapy recommend aerob training, resistance and balance exercises. Various forms of physicotherapy support blood circulation, metabolic recovery, muscle relaxation and joint mobility, and can be effectively applied in older adults. One of the  best modalities to improve microcirculation is Bemer therapy.