Rheumatoid arthritis and the older adult

Rheumatoid arthritis (RA) is the second most common rheumatic disease after osteoarthritis, but it is the most destructive to synovial joints. RA can be defined as a chronic, progressive, systemic, inflammatory disease of connective tissue characterized by spontaneous remissions and exacerbations (flare-ups). Unlike osteoarthritis, it involves primary tissue inflammation rather than joint degeneration. Although most individuals develop RA in early to middle adulthood, some experience a late onset RA (LORA) in their older years. The onset may be acute and severe or slow and insidious, making diagnosis difficult and often delayed. Regardless of the age at onset, RA affects many older adults in both community and inpatient settings and presents a challenge for nursing care.