Aging with IgG4-RD: Managing the disease in your senior years

As you get older, it’s normal for your healthcare needs to change. Aging with immunoglobulin G4-related disease (IgG4-RD) can bring additional challenges, such as managing new symptoms, balancing multiple medications, and staying on top of other health conditions.

While these changes may feel overwhelming at times, understanding what to expect and working closely with your healthcare team can help you maintain your health, independence, and quality of life while living with IgG4-RD.

How aging affects IgG4-RD symptoms

IgG4-RD usually develops between the ages of 50 and 70, so the disease is more common in seniors than among those in younger age groups. It often responds well to treatment, but it is a chronic, relapsing condition, meaning symptoms often return after initially responding to treatment.

Because IgG4-RD was only recognized relatively recently, researchers are still learning how the disease changes with age. Current evidence suggests that IgG4-RD in seniors more commonly affects internal organs, such as the pancreas, biliary tract, lungs, prostate, and other organs in the abdomen. Symptoms affecting the head and neck region, tear ducts, and salivary glands appear to become less common with age. In addition, older adults frequently show signs of the disease in multiple organs, while younger people mostly have involvement of a single organ.

Over time, IgG4-RD may lead to organ damage, making it important to stay aware of any changes in your symptoms. Be sure to let your healthcare team know if you notice new symptoms or if existing symptoms worsen.

Managing treatment side effects in older age

Several medications used to treat IgG4-RD can cause side effects that require careful management as you age.

Steroids are among the most commonly prescribed and effective treatments for IgG4-RD. However, many people require long-term treatment to help prevent disease relapses.

Long-term steroid use can increase the risk of:

• weight gain
• osteoporosis, or weakening of the bones
• muscle weakness
• high blood pressure
• high blood sugar, which can lead to diabetes

Some of these complications may also develop naturally as you get older, so steroids can have a greater impact on seniors. You might want to talk with your doctor about preventive strategies to help reduce these risks.

If steroid side effects become difficult to manage, ask your doctor whether other treatment options may be appropriate for you.

Researchers believe IgG4-RD may be linked to abnormalities involving immune cells called B-cells. Some newer therapies work by reducing the number of B-cells in your body. These medications can be used in IgG4-RD to reduce the need for steroids, but they can weaken your immune system and increase your risk of infection.

Your immune system’s ability to fight infections declines gradually with age, so you may want to take extra precautions to reduce your risk of getting sick when using IgG4-RD medications. These may include:

• washing your hands frequently
• avoiding crowded spaces when possible
• wearing a mask in higher-risk settings
• staying up to date on recommended vaccines

Dealing with other conditions and multiple medications

Managing rare disease as you age can become more complicated if you develop other health conditions. Many older adults live with multiple conditions, called comorbidities, and might take several medications at one time or throughout the day. Taking five or more medications at the same time is known as polypharmacy. Aging can also affect how your body processes medications, which can increase the risk of drug interactions or side effects.

To help manage these risks, consider:

• keeping an updated list of your medications
• sharing medication changes with your healthcare team
• asking about possible drug interactions
• reporting new or worsening side effects promptly
• bringing your medication list to appointments

Open communication with your healthcare team can help ensure that all of your conditions are treated safely and appropriately.

Maintaining mobility and independence

Over time, inflammation and tissue scarring caused by IgG4-RD may lead to organ damage. While treatment can help control the disease and prevent further complications, some existing damage may not be reversible and may lead to permanent organ dysfunction. Proactive management is important to help reduce complications over time.

You can support your health by:

• attending regular medical appointments
• taking medications as prescribed
• monitoring changes in your symptoms
• discussing new concerns with your healthcare team
• adjusting your care plan as your needs change

Because IgG4-RD affects everyone differently, the support you need may change over time. Checking in regularly with your healthcare team and loved ones can help you continue to age as well as possible with the condition.

Questions for your geriatric care team

Geriatric, or older adult, IgG4-RD care can present new challenges as your healthcare needs change over time.

Because many people with IgG4-RD experience relapses despite treatment, telling your healthcare team about new or worsening symptoms promptly can help reduce the risk of organ damage and long-term complications.

You might also want to ask:

• Are there any new treatment options that may be appropriate for me?
• Am I eligible for any clinical trials?
• What can I do to manage or reduce medication side effects?
• How can I protect my bone and muscle health as I get older?
• What strategies can help me maintain my mobility and independence?

Aging with IgG4-RD can bring new challenges, but there are also many ways to support your health and well-being as your needs change. By staying engaged in your care, communicating openly with your healthcare team, and addressing new symptoms early, you can make informed decisions and continue focusing on the activities and relationships that matter most to you.