Particular features of rheumatoid arthritis onset in the elderly

Abstract

Introduction. Rheumatoid arthritis (RA) is a chronic inflammatory disease that can occur at any age, but it can manifest differently in different decades of age. Obvious and significant manifestations of RA occur in those aged ≥65 years. The literature confirms the presence of more severe onset in patients in the eRA (elderly-RA) group compared to patients in the aRA (adultRA) group. Aim of study. To assess the clinical-paraclinical characteristics and joint functional status in elderly patients with RA. Methods and materials. This study included 52 patients diagnosed with RA according to the 2010 ACR/EULAR criteria from 2019-2023. According to the age of disease onset, patients were divided into 2 groups- aRA (<55 years) and eRA (>55 years), also clinical-paraclinical data and radiological expression (by Sharp score) were compared. Results. Female patients predominated in both groups- aRA (67.2%) and eRA (70.1%), with no statistically significant difference (p=0.23).aRA group was specified a longer disease duration but shorter duration of pre-diagnostic symptoms compared to eRA (39±1.0 months vs 34±3.0, p<0.01 and 18±1.0 months vs 25±2.0 months, p=0.002, correspondingly). Extra-articular manifestations were more common in patients with eRA, possibly due to correlation with longer duration of prediagnostic sympathetic symptoms (r=0.89, p<0.01), especially the presence of rheumatoid nodules(45.1% vs 20.2% , p=0.011) and weight loss (by 7.0±0.5 kg in 6 months),(83.1% vs 33.7%, p<0.001). Analyzing the radiological results (according to Sharp score), more patients showed erosions were characteristic in the eRA group (48.7%) than in the aRA group (33.3%, p<0.01). In the eRA group predominantly erosions were determined in the lower limbs compared to the eRA group where they were in the upper limbs. Disease activity according to the DAS28 score (PCR) was similar between the two groups of patients and did not show any statistically significant differences (p>0.05). Conclusion. In the elderly, a longer duration of symptoms was determined before the diagnosis was established, which therefore also determines the presence of extra-articular manifestations. Compared to adults, more patients with bone erosions were found in the elderly and predominantly in the lower limbs. age, but it can manifest differently in different decades o f age. Obvious and significant manifestations of RA occur in those aged ≥65 years. The lit erature confirms the presence of more severe onset in patients in the eRA (elderly-RA) group c ompared to patients in the aRA (adultRA) group. Aim of study. To assess the clinical-paraclinical characteristics and joint functional status in elderly patients with RA. Methods and materials. This study included 52 patients diagnosed with RA according to the 2010 ACR/EULAR criteria from 2019-2023. According to the age of disea se onset, patients were divided into 2 groups- aRA (<55 years) and eRA (>55 years), also clinical-paraclinical data and radiological expression (by Sharp score) were compared. Results. Female patients predominated in both groups- aRA (67.2%) and eR A (70.1%), with no statistically significant difference (p=0.23).aRA group was spe cified a longer disease duration but shorter duration of pre-diagnostic symptoms compared to e RA (39±1.0 months vs 34±3.0, p<0.01 and 18±1.0 months vs 25±2.0 months, p=0.002, correspondingly). Extra -articular manifestations were more common in patients with eRA, possibly due to correl ation with longer duration of prediagnostic sympathetic symptoms (r=0.89, p<0.01), especially the presence of rheumatoid nodules(45.1% vs 20.2%, p=0.011) and weight loss (by 7.0±0.5 kg in 6 m onths),(83.1% vs 33.7%, p<0.001). Analyzing the radiological results (according to Shar p score), more patients showed erosions were characteristic in the eRA group (48.7%) than in the aRA group (33.3%, p<0.01). In the eRA group predominantly erosions were determined in the l ower limbs compared to the eRA group where they were in the upper limbs. Disease activity a ccording to the DAS28 score (PCR) was similar between the two groups of patients and did not s how any statistically significant differences (p>0.05). Conclusion. In the elderly, a longer duration of symptoms was determine d before the diagnosis was established, which therefore also determines the presenc e of extra-articular manifestations. Compared to adults, more patients with bone erosions were f ound in the elderly and predominantly in the lower limbs.