Ageism in Rheumatology: The Health Care Professional's Perspective

Ageism (age-based stereotypes, prejudice, or discrimination) is prevalent and linked to prolonged disability and reduced lifespan in older adults. Little is known about ageism within rheumatology. This study explores the health care professional's (HCP) perception of the care of older adults and how ageist attitudes or perspectives may impact rheumatologic care.

A REDCap survey related to the clinical care of older adults that included the validated Expectations Regarding Aging (ERA-12) instrument (higher scores associated with less age-related bias) was administered to a convenience sample of HCP caring for patients with rheumatic disease. We calculated correlations between ERA-12 scores and the responses to other survey questions.

A total of 255 surveys were collected from January 2023 to December 2023. Respondents were predominantly female (63%), White (70%), physicians (75%), healthcare professionals practicing in academic (66%) or in urban (64%) settings, and most practices having >25% adults over the age of 65 years (88%). The median ERA-12 score was 36 of 48, indicating that respondents, on average, disagreed with the stereotypes regarding aging. Higher ERA-12 scores were associated with greater enjoyment of the care of older adults (P < 0.001) and awareness of the Geriatric 5Ms (mind, mobility, medications, multicomplexity, and matters most (P < 0.001), a framework for improving age-friendly care. Lower ERA-12 scores were associated with believing that older adults are more demanding of attention (P < 0.001) and shifting from disease-modifying therapy to symptom relief in older adults (P < 0.001).

Stereotypical beliefs regarding aging are associated with self-reported changes to patient counseling and medical decision-making, suggesting age-related biases may affect the care of older adults with rheumatic diseases.