Pruritus in the Elderly

INTRODUCTION Pruritus is the most common skin disorder in the geriatric population.1 It is defined as an unpleasant cutaneous sensation that provokes the desire to scratch.2 Acute itch (lasting less than 6 weeks) may provide a protective function, but chronic itch (lasting more than 6 weeks) is mostly a nuisance.3 The prevalence of pruritus increases with age and can be partially attributed to a decline in the normal physiological status of the skin (Table 1).2,4 In a French study, a survey was sent to 10,000 randomly selected households.5 Of 7,500 respondents, 87% reported skin problems since birth and 43% experienced these problems over the 2 years preceding the survey. In addition, 29% of the respondents described their symptoms as burdensome. Of those individuals, more than half indicated that chronic skin disorders, with pruritus as the primary symptom, impaired daily activities. Moreover, in a study of skin disorders in 68 noninstitutionalized persons, two-thirds of the group and 83% of octo genarians reported medical concerns regarding their skin, with pruritus the most frequent complaint.6 In a study conducted in Norway, itching was the predominant skin complaint in subjects ranging from 30 to 76 years of age.7 Chronic pruritus can have a significant effect on quality of life, because therapies for acute pruritus often do not ameliorate chronic disease.8 In many people, itching is not just an occasional problem; it can have debilitating effects, such as sleep impairment, that can result in clinical depression. In fact, many people with chronic itching can become so depressed that they would rather live a shorter life free of symptoms than a longer life with pruritus.8 Studies have shown