Giant cell (temporal) arteritis and polymyalgia rheumatica, which often occur together, affect people over age 55 almost exclusively. These disorders become more common as people age. They are 10 times more common among people over age 80 than among those aged 50 to 59.
Giant cell arteritis typically causes a throbbing headache and problems with vision (including pain in and around the eyes). Polymyalgia rheumatica makes muscles painful and stiff. Without treatment, the pain these disorders cause, whether they occur together or separately, can make everyday living miserably difficult. Also, without prompt treatment, giant cell arteritis can cause blindness.
The main treatment of these disorders, corticosteroids, may be problematic in older people. These drugs can cause dramatic improvement and are essential for preventing blindness. However, they are more likely to have side effects in older people. People may retain fluids, their appetite may increase, and they may become confused. Blood sugar may increase, sometimes causing diabetes, and bone density may decrease. Blood pressure may increase. To reduce the risk of these effects, doctors reduce the dose of the corticosteroid and stop the drug as soon as possible.
Older people who take corticosteroids are encouraged to take measures to help maintain bone density. They can do weight-bearing exercise and take calcium and vitamin D supplements. Taking antiresorptive drugs can help increase bone density. Such drugs include bisphosphonates (alendronate, risedronate, ibandronate, and zoledronic acid).
Faithfully continuing treatment as instructed results in complete recovery for many people.