Osteoarthritis in the Elderly

Abstract

Osteoarthritis is the most common cause of chronic disability in older adults. It is a slowly progressive degenerative disorder of articular joints that has multiple etiologies with age being a key factor. Osteoarthritis most commonly affects the hands, knees, hips and spine with knee osteoarthritis representing a major cause of pain and activity limitation. Current therapies are focused on symptom relief while interventions proven to slow or stop the structural progression of the disease are not yet available. No longer considered a “wear and tear” condition that is an inevitable consequence of aging, it is becoming increasingly evident that osteoarthritis has elements of chronic inflammation associated with an imbalance in anabolic and catabolic activity within affected joint tissues. Age-related changes in the cells and tissues of the joint, including cell senescence, oxidative stress, a decline in autophagy, epigenetic alterations, and matrix damage all appear to contribute to the development and progression of osteoarthritis. Which of these may serve as effective targets will be a key question to address in the search for disease modifying interventions.