A journey inside the elderly-onset primary Sjögren’s syndrome, looking for useful tips for the geriatrician

Abstract

Primary Sjögren’s syndrome (pSS) is a systemic autoimmune rheumatic disease where xerophthalmia, xerostomia and presence of anti-SSA and anti-SSB antibodies are typical features. Its prevalence is higher in over-65 aged population than in other age groups. In the elderly, pSS diagnosis comes up against a whole series of critical points that may favor its misdiagnosis. The aim of our article is to discuss the most relevant of them: the frequent occurrence of a seronegative subset, the presence of systemic features not related to sicca syndrome, the sicca syndrome as iatrogenic manifestation and the possibility of a biopsy false negative of labial salivary glands.

Does a steroid dementia syndrome really exist? A brief narrative review of what the literature highlights about the relationship between glucocorticoids and cognition

“…For instance, some systemic diseases requiring treatment with GCs may cause cognitive impairment themselves. Primary Sjogren's syndrome (pSS) is a systemic autoimmune inflammatory disease not seldom diagnosed in elderly people; 22 pSS may cause cognitive impairment (from the so-called Sjögren's Syndrome fog to a frank dementia). 23 In some pSS patients, treatment with GCs is mandatory.…”