Hardt R
Geriatrische Klinik, Geriatrische Schlaganfalleinheit, Katholisches Klinikum Mainz, Hildegardstr. 2, 55131, Mainz, Deutschland.
Z Rheumatol. 2012 Jul;71(5):396-402. doi: 10.1007/s00393-011-0868-5.
The demographic shift is leading to a rapid rise in the number of elderly citizens. Accordingly, the number of geriatric problems is also increasing within the population of rheumatic patients. Geriatric patients are characterized through the triad of high age, multimorbidity and functional deficits. Almost all will show signs of arthritis and other degenerative musculoskeletal illnesses. Inflammatory rheumatic diseases within the geriatric population are found to be mostly in the chronic stage or with defective conditions. Problems typical of this population, such as comorbidities especially in the cardiovascular sector, must be assessed prior to the application of therapeutic concepts. The focus is on activating therapies, such as physiotherapy and occupational therapy, where the functional usefulness is proven. The use of thermal therapy, especially applied in the form of heat, as well as electrotherapy and high frequency therapy are also useful when indicated. Balneotherapy and hydrotherapy, as well as massage therapy and lymphatic drainage, must be adapted to the cardiovascular function of geriatric patients; this applies especially to heart failure patients. Physical therapy concepts in elderly rheumatic patients should preferably be implemented and managed by a multidisciplinary geriatric team.
人口结构的转变正导致老年公民数量迅速增加。相应地，在风湿性疾病患者群体中，老年问题的数量也在增加。老年患者的特征是高龄、多种疾病并存和功能缺陷三联征。几乎所有老年患者都会出现关节炎和其他退行性肌肉骨骼疾病的症状。老年人群中的炎性风湿性疾病大多处于慢性阶段或存在功能障碍。在应用治疗方案之前，必须评估该人群的典型问题，如特别是心血管方面的合并症。重点是激活疗法，如物理治疗和职业治疗，其功能效用已得到证实。在有指征时，热疗（尤其是以热敷形式应用）以及电疗和高频治疗也很有用。浴疗和水疗，以及按摩疗法和淋巴引流，必须适应老年患者的心血管功能；这尤其适用于心力衰竭患者。老年风湿性患者的物理治疗方案最好由多学科老年团队实施和管理。
