[Follow-up of rheumatoid arthritis beginning in advanced age]

Two cohorts of 125 patients each, with different onset of disease (group A = before the age of 55, group B = after the age of 54) were selected from a total of 1000 patients with definite rheumatoid arthritis (RA). Both groups were identical with regard to gender (women = 71%) and duration of disease (mean = 7 years). Mean age was in group A = 47, in group B = 68 years, respectively. When compared, in both samples no significant differences were found with regard to acuity of onset, to occurrence and duration of a period with nonspecific complaints prior to synovitis and to incidence of remissions and fever. However, in the elderly onset group progression of disease was significantly higher, the functional status poorer, dynamometer values lower, and the frequency of systemic signs higher. Furthermore, in the late onset group were more rarely reported regular exercise programs, other rehabilitative measures, treatment with gold preparations, and joint surgery. These features seem to indicate that age at onset has a modifying effect on disease expression in RA. One factor of influence, among others, is likely to be the generally decreased functional level in higher age. Late onset RA is not thought to be a separate entity of the disease.