Do patients with elderly-onset rheumatoid arthritis have severe functional disability?

Area of Science:

• Rheumatology
• Geriatric Medicine
• Clinical Epidemiology

Background:

• Rheumatoid arthritis (RA) can manifest at various ages, with elderly-onset RA (EORA) presenting unique clinical characteristics.
• Understanding the long-term impact of EORA on disease outcomes is crucial for effective patient management.

Purpose of the Study:

• To investigate the clinical features of EORA.
• To determine the impact of EORA on functional disability and disease outcomes.

Main Methods:

• A cohort of 3169 RA patients was stratified by age at onset: <40 (younger), 40-59 (middle-aged), and ≥60 years (EORA).
• Clinical features and functional disability (Health Assessment Questionnaire-Disability Index [HAQDI]) were analyzed using ANOVA, chi-squared tests, and multivariable logistic regression.

Main Results:

• In bivariable analysis, EORA was associated with high HAQDI. However, multivariable analysis identified patient age, female gender, high disease activity, disease duration >10 years, and cardiovascular comorbidity as key factors.
• In patients with disease duration <10 years, EORA was an independent predictor of functional disability (OR 3.04). This association was also significant for disease durations <5 years (OR 3.07) and 5-10 years (OR 3.04).

Conclusions:

• Elderly onset of rheumatoid arthritis is an independent risk factor for functional disability in patients with a disease duration of less than 10 years.
• These findings underscore the importance of early intervention and tailored management strategies for EORA patients.