The High Prevalence of Skin Diseases in Adults Aged 70 and Older

Suvi-Päivikki Sinikumpu, MD, PhD; Jari Jokelainen, MSc; Anna K. Haarala, MD; Maija-Helena Keränen, MD; Sirkka Keinänen-Kiukaanniemi, MD, PhD; Laura Huilaja, MD, PhD

Disclosures

J Am Geriatr Soc. 2020;68(11):2565-2571. 

In This Article

Abstract and Introduction

Abstract

Background/Objectives: To determine the prevalence of skin findings and skin diseases in adults aged 70 and older, and to study the association between cutaneous diseases and socioeconomic status (SES), sex, and living status in the older population.

Design: Cross-sectional study of Finnish adults aged 70 to 93 as part of the Northern Finland Birth Cohort 1966 Study.

Settings: Skin examination data were available for 552 adults.

Measurements: A whole-body skin examination was performed by dermatologists. The associations between skin diseases and SES, sex, and living status were analyzed.

Results: Nearly 80% of the adults had at least one skin disease that required further treatment or follow-up. More than one-third of the study cases (39.1%) had three or more simultaneous skin diseases. Skin diseases were more common in men than in women (P < .001). The most common skin diseases were tinea pedis (48.6%), onychomycosis (29.9%), rosacea (25.6%), actinic keratosis (22.3%), and asteatotic eczema (20.8%). Some association was found between skin diseases and SES and living status.

Conclusion: A whole-body clinical skin examination is important because it reveals important diagnoses.

Introduction

The proportion of older individuals is growing rapidly, especially in developed countries. Globally, approximately 1.5 billion people are estimated to be aged 65 and older in 2050.[1] Aging causes a variety of intrinsic and extrinsic changes in the skin, making it more prone to cutaneous diseases.[2] Skin diseases decrease quality of life and worsen active aging.[3,4]

Although skin disorders are common in the older population, few epidemiological studies have detailed cutaneous diseases among older persons. Furthermore, most available data have been collected from selected geriatric populations, such as residents of nursing homes or those treated in the tertiary care setting. Studies in the general population are lacking.[5] Two large studies based on hospital records of 4,000 Turkish and 16,924 Taiwanese older persons revealed that the most common skin diseases in older people are eczemas, skin infections, and pruritus.[6,7] Two other studies carried out in dermatological clinics in India (n = 300) and in Turkey (n = 7,092) reported similar findings in patients aged 60 to 99, consisting mainly of cases of xerosis, skin infections, and vascular diseases.[8,9] Xerosis and dermatophytosis were also the most prevalent skin diseases in a study of 233 nursing home residents in Germany.[5] Other cutaneous disorders common in older adults include benign and malignant skin tumors, infestations, and chronic wounds.[5,10,11]

Because few epidemiological studies based on clinical examination have been conducted in older populations, the present study was designed primarily to determine the prevalence of abnormal skin findings and cutaneous diseases in a population of individuals aged 70 and older. The other aim was to determine whether the prevalence of skin diseases in older persons is associated with socioeconomic status (SES), sex, and living status.

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