Dry Eye and Dry Mouth in the Elderly

Abstract

SYMPTOMS OF dry eye and dry mouth are common in the elderly and are frequently debilitating. When an individual presents with sicca symptoms, particularly if accompanied by musculoskeletal or other systemic complaints, considerations relating to the diagnosis of Sjogren syndrome arise, and an evaluation for evidence of an autoimmune process may ensue. In the United States, research on the epidemiology of sicca symptoms has largely been limited to selected populations such as outpatient clinics or nursing homes^1-5 where a variety of selection biases are likely to play a significant role in both estimates of the prevalence of symptoms as well as their relationship to systemic disease or other factors. We have previously reported the relationship between tests (Schirmer and Rose Bengal) and symptoms of dry eye and the prevalence of dry eye by varying definitions.^6-8 In summary, no significant association was seen between report of dry eye symptoms and either Rose Bengal or Schirmer testing nor was there any meaningful association between the results of Rose Bengal and Schirmer tests. Overall, 14.6% of the population reported symptoms of dry eye to be present often or all the time, and 3.5% were symptomatic and had either Rose Bengal scores or Schirmer test results in the lowest decile. Symptoms of dry mouth were found in 17% of the population and were closely associated with a measure of salivary production, the Saxon test.^9,10