Gout

Gout: age and experience

People we spoke to, like Sue, mentioned that gout is often perceived as being an older man’s disease. Around 2-3% of adults in the UK have gout (Kuo et al., 2015). The chances of getting gout do increase as people get older but gout can affect men of any age, whereas women are more likely to develop gout after the menopause. Because of these patterns, the older men we spoke to had often been living with gout for many years, whereas older women were likely to have been diagnosed more recently. 

Some people felt that being diagnosed with gout made them feel older, and/or slightly embarrassed because they saw it as an older persons’ condition. 

Val felt that having gout, and not being able to wear the shoes she wanted to, made her feel older and less feminine.

Val felt that having gout, and not being able to wear the shoes she wanted to, made her feel older and less feminine.

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Well the main thing with me has been shoes. I can’t … couldn’t get many of my shoes on and I kept thinking, “Oh it’ll go down, it’ll go down”. But I did get sent for an x-ray and they said that I had arthritis in both big toe joints. And so I thought, “Well if I’ve got arthritis and this gout’s come along to add a bit more to it, I probably am never going to get those shoes on again”. Which in fact was true, I couldn’t get the shoes on again. And that, because they were girlie shoes, that really was a disappointment. I know it might sound a bit trivial to people but it’s like your image of who you are isn’t it? And I felt very old as well. You know that kind of feeling, “Oh dear I’ve joined the old age pensioners now”, you know.

Because of the shoes? 

No, no the shoes and the gout, you know, the fact that … in fact I haven’t told many people I’ve got gout. 

Why do you think that is? 

Because it feels so old I think. It feels as though it’s something that people sort of in their dotage have, not young people. Or young … I mean I’m not young, but in my head I’m young, yeah. 

Alastair felt that gout was seen as an older person’s condition and did not want to think of himself as being old.

Alastair felt that gout was seen as an older person’s condition and did not want to think of himself as being old.

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When I first got it, I guess I was slightly embarrassed, you know, because you do think of it as an old person’s disease. Not that there’s anything wrong with being old, I mean I’m really rather glad to have got this old [laughs], but one has a tendency not to think of oneself as being old, you know, but gradually, I guess, you just have to accept it. I think there is the notion that it is an older person’s disease and, you know, for that reason, depending on your own sort of self-image, most people don’t want to think of themselves as being old, you know, and to have an old person’s disease sort of shunts you into a category, you know so…
Some people have attacks of gout every few years, whereas others have them more frequently. The frequency of attacks tends to increase over time. Harry found that his attacks became more frequent and more severe as he got older. He wondered if this was because his internal organs were working less well than when he was younger. Other people found that their attacks were less frequent as they got older – often because they started taking medication to prevent them. 

Even if people had not noticed changes in the frequency or intensity of symptoms, they often had questions about the future and ageing with gout. Some worried about the possibility of long-term damage from gout as they grew older. Others wondered whether gout was caused by their kidneys working less efficiently, and if this would cause other problems later in life. Sam was particularly worried that if she got less active as she got older, her gout would become worse. Some people were concerned about how their symptoms might progress in the future, especially if they were diagnosed relatively young and were already at a particular stage. Others had no concerns about how gout might affect them as they got older.

Eddie worries about losing his independence if his attacks get more frequent as he gets older.

Eddie worries about losing his independence if his attacks get more frequent as he gets older.

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I got a bit fearful because I thought that the older I get, it could be the more gout I’ve got for some reason or another, and that it would slowly wear me down. Yeah I did worry about that slightly, because you know, coming back to living on your own, one of the things you fear mostly living on your own, you cannot look after yourself, I’ve just had two or three friends who can’t look after themselves and they’ve gone into a home and you know we visit them there and you think, “Oh please not me.” You know, they’re well looked after don’t get me wrong or anything but it’s not like your own home you see, and that’s what’s fearful, that the times comes that I might not be able look after myself if I get too bad. Even though, you know, you have an attack and it goes you don’t know if they’re going to get closer and closer together, so yeah it does worry you slightly.
Some people felt that their attitudes had changed as they got older, and that they had also learnt from past experiences of gout. Several talked about thinking ‘it’s not going to happen to me’ when they were younger, whereas they now took gout more seriously. Eric believed that getting older had made no difference to the level of pain he experienced from attacks, but that he had learnt to accept that he had the condition. Other people had decided that it was best to not to worry about gout because it would not help them. Jean felt that she was less likely to worry about gout because she had reached the age of 78 and was still generally managing fine. Shirley felt that the different mindset she had now she was older made it easier to cope with the pain. Janette said that, because she was older, she knew herself well and that she could stick to the dietary changes she had made. People’s priorities in terms of managing gout were also sometimes different from their priorities earlier in life. Sometimes this was because they felt they had less time to do what they wanted to with their lives.

Getting older has made Arthur more determined to get his gout controlled so that it does not impact his leisure and social activities.

Getting older has made Arthur more determined to get his gout controlled so that it does not impact his leisure and social activities.

Age at interview: 63
Sex: Male
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I’m probably more anxious now to try and identify what the problem is, because as I’m getting older, you’ve got less time. Now I don’t…we’ve got a lot we want to pack into our lives, okay. We want to do a lot more travelling. Our social life, you know, we’ve got a lot we want to do. Now I know at the back of my mind, that if I get an attack, that’s knocked on the head, so that impacts quite severely on what we want to achieve. So the long term prospect for me is, that I want to get it sorted because what time I’ve got left in my lifespan, I don’t want to be messing about with gout and trying to sort that out because I’ve got other things I want to do, so it’s a bit frustrating.
Having gout for a number of years means that Jacqui has been able to integrate lifestyle changes into her day-to-day routine. She is always aware, for example, of making sure she drinks enough water. Carole felt that she learnt over time to recognise and deal with flares sooner. Michael felt that, had he got gout when he was younger, it would have had more impact because he would have had a more active lifestyle. 

While many people felt that age and experience had influenced their life with gout in a positive way, some had noticed negative impacts as well. Eddie felt that being older meant that it took longer for his body to recover from attacks. Gerald also felt that gout attacks affected him more since he got older. 

Gerald used to feel he could go to work or the pub when he had an attack, but no longer wants to. He feels that attacks ‘take the stuffing out’ of him more now.

Gerald used to feel he could go to work or the pub when he had an attack, but no longer wants to. He feels that attacks ‘take the stuffing out’ of him more now.

Age at interview: 67
Sex: Male
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And do you think that your experience of gout has changed as you’ve got older. Has your age made a difference to anything?

It just slows me down more. I mean, like I said to you, when I’d had it, when I was [working for the company], when I was working at least I – I used to go to work and go with it and I’d try and I’d go down the pub with it, but now I never, now with the age, no. Yeah I mean, say now, you can’t, you can’t, you don’t want to get out, you don’t want... Like when I was like forties, I’d go out, I’d put up with the pain and go down the pub and – they can laugh at me, you know, I’d go up with my open sandal on or me slipper on and I wasn’t, you wouldn’t be bothered. But now, I’d sooner sit here and just, you know. No, because it, it takes the stuffing out of you more, more now. So…
Some people expected to have more health issues as they got older so, when they were diagnosed with gout, they accepted it as one of these conditions. Michael felt that this could sometimes minimise the impact of having gout because it could be seen as just one of the conditions people get as they get older. Shirley felt that this was one reason why her GP did not take her gout as seriously. 

People who got gout at a younger age were often surprised at the diagnosis because they thought it was something that only affected older people. Younger women were particularly likely to find their diagnosis difficult to accept. Both men and women sometimes felt that it was unusual to have gout at a younger age, and had not come across anyone else of a similar age with it. John Z was in his late 20s and working as a doctor when he was diagnosed with gout. He had rarely come across patients with it under the age of 60. (For more see ‘Feelings about the diagnosis of gout’).

John Y felt strange being diagnosed with gout in his 40s when he thought of it as being an older person’s condition.

John Y felt strange being diagnosed with gout in his 40s when he thought of it as being an older person’s condition.

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So can I take you back to when you were first told that it was gout that you’d got. 

Yeah. 

How did you feel about that?

Well I felt strange, because it’s, like I said, it’s an old man’s, or you think it as being an old man, I mean Henry VIII had it, didn’t he, or George IV had it and they were, I suppose perhaps even a bit younger than me. And, you know, you sort of think, “Well it’s a strange thing to have really”.
Jonathan was diagnosed in his 30s and wondered what impact gout might have on his activities and everyday life. He thought it was important for people diagnosed at a younger age to have access to information about what might happen in the long-term. When Paula was diagnosed, the thought of living with gout for many years worried her. Doctors reassured Tony and Ray that gout could be controlled with daily medication so they did not worry about the prospect of living with it for many years.  (For more see ‘Long-term treatment to lower uric acid and prevent gout attacks and long-term problems’ and ‘Thoughts about the future and long-term effects of gout’).



Last reviewed December 2016
Last updated December 2016

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