Background: The current evidence about the clinical characteristics and the impact of fibromyalgia (FM) in the elderly population, when compared to younger individuals, is still scarce and contradictory. Due to the lack of specific information on the subject, there are no specific recommendations yet for the monitoring and treatment of fibromyalgia (FM) in this population, which has its own age-related characteristics and deserves differentiated care. Objectives: To evaluate the impact and severity of symptoms in elderly FM patients (> 60 years), comparing with younger patients. Methods: Cross-sectional observational study, conducted from June to December 2023, at Hospital das Clínicas, Federal University of Pernambuco. Inclusion criteria: FM diagnosis, age ≥ 18 years, and regular clinical follow-up. Exclusion criteria: Diagnosis of autoimmune disease, male gender, and incomplete data in the medical record. Demographic and clinical data were collected, including the Fibromyalgia Severity Scale (FSS), composed of the sum of Widespread Pain Index (WPI) and Symptom Severity Scale (SSS), and the Fibromyalgia Impact Questionnaire Revised (FIQ-R). For analysis, the patients were divided into two groups: Group 1: < 60 years and Group 2: ≥ 60 years. Results: A total of 265 female patients were evaluated, being 182 (70.8%) in group 1 and 75 (29.0%) in group 2. The mean age at group 1 was 49.7 (7.0 years) and 65.0 (4.3) years at group 2 (p<0.001). Related to treatment, it was observed that patients in group 1 underwent psychotherapy more frequently (p=0.030; OR=0.22; CI95% 0.05-0.97), as well as a higher frequency of use of pregabalin (p=0.033; OR =0.40; CI95% 0.17-0.95). No difference was observed in relation to therapeutic failure or adverse events between the two groups. There was no difference related to exercise practice (frequency, or duration of physical activity/week), and the practice of aerobic activities was more frequent in group 1(p=0.035; OR=1.79; CI=1.04-3.09). Patients in Group 1 had all FIQ-R and FSS scores worse than those in group 2 (Figure 1), as well as the frequency and severity of fatigue (p<0.001), non-refreshing sleep (p= 0.011), cognitive symptoms (p=0.049), headache (p<0.001; OR=5.07; CI95% 2.66- 9.66) and abdominal pain (p=0.012; OR=2.07, CI95% 1.16-3.70). Conclusion: This study provides significant insights into the clinical characteristics and treatment approaches of FM in elderly patients. The notable divergence in symptom severity between older and younger FM patients suggests a potential variation in the progression or better perception of FM symptoms with age. These findings underscore the necessity for a tailored approach in managing FM, considering the age-related differences in symptoms and treatment responses and emphasizes the importance of individualized treatment plans that account for age-specific characteristics and challenges faced by the elderly population. Future research should focus on developing age-specific guidelines for FM management, enhancing the quality of life for all patients irrespective of their age. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
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