Clinical, Laboratory Characteristics, Comorbidity and Function in Elderly patients with Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease affects several body systems as well as the synovial tissue. RA decreasing the health related quality of life (QoL) and functional abilities. Many challenges in the management of elderly RA because of the presence of “geriatric syndromes” as frailty, mobility, risk of falls, fractures and polypharmacy, all of which have an effect on the disease course and treatment.Objectives: To evaluate the clinical, laboratory and comorbid characteristics of elderly RA patients and its impact on function and quality of life.Patients and methods: Sixty elderly RA of both sexes aged ≥ 60 years fulfilling the 2010 EULAR/ACR classification criteria.Comprehensive geriatric assessment (CGA), CBC, FBS, 2hr PP, thyroid function tests, lipid profile, ESR, CRP, ACPA, RF, liver and kidney function, uric acid, BMI, DAS28-CRP, VAS and HAQ score.Results: Significant reduction in health QoL regarding mobility, fall risk, depression scale, significant elevated levels of ACPA, RF, ANA, high disease activity score -28 CRP (> 5.1).Significant association with disease comorbidity factors; hypertension (p=0.632), cerebrovascular (p <0.001), cardiovascular (p < 0.001), diabetes (p < 0.001), respiratory disease (p < 0.001) and methotrexate treatment.Conclusion: Elderly RA patients showed impaired function and lowered health QoL. Comorbidity and markers of disease activity were higher in elderly RA therefore, when treating elderly RA careful attention is needed to associated comorbidities, treatment should aimed at achieving adequate control and clarifying the complex interrelationship between elderly RA and their associated “geriatric syndromes”.