Elderly with rheumatoid arthritis can cope well

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Many elderly people with rheumatoid arthritis may go about their daily activities with no more problem than others their age, a new study suggests.

In the study of older men and women, those who had rheumatoid arthritis were, on average, able to walk, climb stairs and take care of themselves as well as the others, researchers in Finland found.

Rheumatoid arthritis (RA) is a chronic disease in which the immune system mistakenly attacks the joints, leading to inflammation, pain and stiffness—and, over time, joint destruction and disability.

The lack of difference between RA patients and other elderly folk in this study was something of a surprise, noted lead researcher Dr. Markku Kauppi of the Rheumatism Foundation Hospital in Heinola.

The finding, Kauppi told AMN Health, likely reflects the success of various RA treatments, such as disease-modifying medications that slow RA progression, physical therapy and prosthetic replacements for seriously damaged joints.

For their study, the researchers analyzed health data on 600 men and women older than 75 from one Finnish town. Sixteen, or just under 3 percent, had been diagnosed with RA.

Of the RA patients, half received the best possible score on a standard scale that measures independence in daily activities like walking, stair climbing, dressing and bathing. That compared with 40 percent of the rest of the study group.

Still, three RA patients, or 19 percent, were judged to be severely disabled, versus only 4 percent of men and women without the condition. Serious disability was “strongly associated with the presence of dementia,” the team reports in the Annals of the Rheumatic Diseases.

Older adults with RA are not at increased risk of dementia, Kauppi said, as there is evidence that they may even have a lower risk of Alzheimer’s disease, the most common form of dementia.

However, when a person with RA develops dementia, it’s likely to speed functional decline, according to Kauppi. People with significant arthritic joint damage, the researcher noted, need to have the skills to compensate for their difficulties performing daily activities—by, for instance, using assistive devices to get around.

“Dementia,” Kauppi said, “may make it impossible for an RA patient to find solutions to daily problems and to compensate (for) joint destruction.”

SOURCE: Annals of the Rheumatic Diseases, January 2005. 

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