Ageism in Rheumatology: The Health Care Professional's Perspective.

Area of Science:

• Rheumatology
• Geriatrics
• Medical Ethics

Background:

• Ageism, defined as age-based stereotypes, prejudice, or discrimination, is a significant issue linked to adverse health outcomes in older adults, including prolonged disability and reduced lifespan.
• While prevalent in general society, the extent and impact of ageism within the specialized field of rheumatology remain largely unexplored.
• Understanding healthcare professionals' (HCPs) perceptions is crucial for identifying and mitigating age-related biases in rheumatologic care.

Purpose of the Study:

• To investigate healthcare professionals' (HCPs) perceptions of caring for older adults within rheumatology.
• To explore how ageist attitudes or perspectives may influence the delivery of rheumatologic care to elderly patients.
• To assess the correlation between age-related biases and clinical decision-making in rheumatology.

Main Methods:

• A REDcap survey was administered to a convenience sample of HCPs specializing in rheumatic diseases.
• The survey incorporated the validated Expectations Regarding Aging (ERA-12) instrument to measure age-related bias (higher scores indicate less bias).
• Correlations were analyzed between ERA-12 scores and other survey responses regarding the clinical care of older adults.

Main Results:

• A total of 255 surveys were collected, with respondents predominantly being female physicians in academic, urban practices with a high percentage of older adult patients.
• The median ERA-12 score (36/48) suggests that, on average, respondents disagreed with common stereotypes about aging.
• Higher ERA-12 scores correlated with increased enjoyment in caring for older adults and greater awareness of the Geriatric 5Ms framework. Conversely, lower scores were linked to perceptions of older adults being more demanding and a tendency to shift from disease-modifying therapy to symptom relief.

Conclusions:

• Stereotypical beliefs about aging are associated with self-reported modifications in patient counseling and medical decision-making among rheumatology HCPs.
• These findings suggest that age-related biases may significantly affect the quality of care provided to older adults with rheumatic diseases.
• Addressing ageism within rheumatology is essential for ensuring equitable and effective patient care.