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Recent onset arthritis in the elderly: a 5 year longitudinal observational study.
J Rheumatol. 2000 Jan; 27(1):101-8.JR

Abstract

OBJECTIVE

To study the spectrum of diagnoses, course, and outcome of recent onset arthritis after the age of 60, presenting as rheumatoid arthritis (RA)-like disease.

METHODS

A 5 year longitudinal observational study enrolled 92 consecutive patients (median age 73 yrs, 54/38 women/men, median duration of arthritis 12 weeks at inclusion).

RESULTS

Forty-eight percent were classified as having RA according to the 1987 American Rheumatism Association criteria, 52% as non-RA (41.4% undifferentiated seronegative polyarthritis, 10.8% oligoarthritis with polymyalgic symptoms). Symmetrical involvement of small and medium size joints was more predominant in the RA (91 and 84%, respectively) than the non-RA patients (58 and 52%). The patients with RA compared to non-RA had more active and serious disease at onset, reflected by significant differences in number of swollen joints (median values 18 and 9, respectively), duration of morning stiffness (75 and 10 min), physician's global assessment of disease activity (45 and 28 mm on visual analog scale), and Health Assessment Questionnaire (HAQ) score for functional disability (1.8 and 1.0). Improvement during the course was observed in disease process variables as well as in HAQ disability score for both RA and non-RA patients. Risk factors for a poor 5 year functional outcome were female sex (OR 4.24), diagnosis of RA (OR 3.28), and baseline HAQ score > or =1.4 (OR 3.52). The median change in radiological progression (Larsen-Dale index) was zero. Twenty patients died during followup, the majority from cardiovascular diseases, infections, and malignancies. Mortality compared to the age and sex matched general population was increased for rheumatoid factor (RF) positive patients (standardized mortality ratio 272). Mortality risk factors within the patient cohort were male sex (OR 4.35), age (OR 1.17), and having RF+ RA (OR 11.93).

CONCLUSION

Arthritis in the elderly is a heterogeneous group of arthritides with an overall favorable functional prognosis. The subgroup of women with elderly onset RA with functional disability at onset is at risk for a less favorable functional outcome. Mortality was increased for the patients with RF+ elderly onset RA only.

Authors+Show Affiliations

Oslo City Department of Rheumatology, Diakonhjemmet Hospital, Norway.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10648025

Citation

Glennås, A, et al. "Recent Onset Arthritis in the Elderly: a 5 Year Longitudinal Observational Study." The Journal of Rheumatology, vol. 27, no. 1, 2000, pp. 101-8.
Glennås A, Kvien TK, Andrup O, et al. Recent onset arthritis in the elderly: a 5 year longitudinal observational study. J Rheumatol. 2000;27(1):101-8.
Glennås, A., Kvien, T. K., Andrup, O., Karstensen, B., & Munthe, E. (2000). Recent onset arthritis in the elderly: a 5 year longitudinal observational study. The Journal of Rheumatology, 27(1), 101-8.
Glennås A, et al. Recent Onset Arthritis in the Elderly: a 5 Year Longitudinal Observational Study. J Rheumatol. 2000;27(1):101-8. PubMed PMID: 10648025.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recent onset arthritis in the elderly: a 5 year longitudinal observational study. AU - Glennås,A, AU - Kvien,T K, AU - Andrup,O, AU - Karstensen,B, AU - Munthe,E, PY - 2000/1/27/pubmed PY - 2000/2/26/medline PY - 2000/1/27/entrez SP - 101 EP - 8 JF - The Journal of rheumatology JO - J Rheumatol VL - 27 IS - 1 N2 - OBJECTIVE: To study the spectrum of diagnoses, course, and outcome of recent onset arthritis after the age of 60, presenting as rheumatoid arthritis (RA)-like disease. METHODS: A 5 year longitudinal observational study enrolled 92 consecutive patients (median age 73 yrs, 54/38 women/men, median duration of arthritis 12 weeks at inclusion). RESULTS: Forty-eight percent were classified as having RA according to the 1987 American Rheumatism Association criteria, 52% as non-RA (41.4% undifferentiated seronegative polyarthritis, 10.8% oligoarthritis with polymyalgic symptoms). Symmetrical involvement of small and medium size joints was more predominant in the RA (91 and 84%, respectively) than the non-RA patients (58 and 52%). The patients with RA compared to non-RA had more active and serious disease at onset, reflected by significant differences in number of swollen joints (median values 18 and 9, respectively), duration of morning stiffness (75 and 10 min), physician's global assessment of disease activity (45 and 28 mm on visual analog scale), and Health Assessment Questionnaire (HAQ) score for functional disability (1.8 and 1.0). Improvement during the course was observed in disease process variables as well as in HAQ disability score for both RA and non-RA patients. Risk factors for a poor 5 year functional outcome were female sex (OR 4.24), diagnosis of RA (OR 3.28), and baseline HAQ score > or =1.4 (OR 3.52). The median change in radiological progression (Larsen-Dale index) was zero. Twenty patients died during followup, the majority from cardiovascular diseases, infections, and malignancies. Mortality compared to the age and sex matched general population was increased for rheumatoid factor (RF) positive patients (standardized mortality ratio 272). Mortality risk factors within the patient cohort were male sex (OR 4.35), age (OR 1.17), and having RF+ RA (OR 11.93). CONCLUSION: Arthritis in the elderly is a heterogeneous group of arthritides with an overall favorable functional prognosis. The subgroup of women with elderly onset RA with functional disability at onset is at risk for a less favorable functional outcome. Mortality was increased for the patients with RF+ elderly onset RA only. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/10648025/Recent_onset_arthritis_in_the_elderly:_a_5_year_longitudinal_observational_study_ L2 - http://www.diseaseinfosearch.org/result/592 DB - PRIME DP - Unbound Medicine ER -