RESEARCH - Late onset RA: Clinical and laboratory comparisons with younger onset patients

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Archives of Gerontology and Geriatrics

Volume 42, Issue 2 , March-April 2006, Pages 225-231

Late onset rheumatoid arthritis: Clinical and laboratory comparisons with

younger onset patients

Nuran Turkcapara, Ozgur Demirb, Teslime Atlic, Murat Kopuka, Murat

Turgaya, Gulay Kiniklia and Murat Dumana

aAnkara University, School of Medicine, Department of Clinical Immunology

and Rheumatology, 06100 Sihhiye, Ankara, Turkey

bAnkara University, School of Medicine, Department of Internal Medicine,

06100 Sihhiye, Ankara, Turkey

cAnkara University, School of Medicine, Department of Geriatric Medicine,

06340 Dikimevi, Ankara, Turkey

Abstract

We aimed to compare the clinical and laboratory profiles of the patients

presenting late onset rheumatoid arthritis (LORA) with younger onset

rheumatoid arthritis (YORA) patients. During the period between January 1995

and December 2004, 124 patients with LORA were identified from a

retrospective chart review of inpatients and outpatients. They were compared

with 150 YORA patients examined during the same period including their

clinical and laboratory findings. The mean ages of the patients with LORA

and YORA were 71.7 ± 5.9 years, and 52.1 ± 11.5 years, respectively. The

gender ratio (female/male) was 1.48 in LORA and 2.85 in YORA (p = 0.012).

The average ages of the disease onset were 42.2 ± 10.4 years in YORA and

68.4 ± 4.6 years in LORA. The duration of the diagnosis was longer in LORA

than in YORA (20.7 ± 14.3 months versus 10.3 ± 6.2 months, p < 0.001).

Rheumatoid arthritis (RA) duration was shorter in LORA than in YORA (43.5 ±

64.4 months versus 126.3 ± 101.0 months, p < 0.001). Although LORA patients

had more significant frequent shoulder joint involvements (p < 0.001),

proximal interphalangeal (PIP), metacarpophalangeal (MCP), elbow,

metatarsophalangeal (MTP) and ankle involvements were common in YORA. Wrist,

knee and hip involvements were not different in the groups. Classical

rheumatoid hand deformities, interstitial lung disease and Sjögren's

syndrome (SS) were significantly lower in LORA than in YORA. LORA patients

had more common weight loss, myalgia, lymphadenopathy, polymyalgia

rheumatica (PMR)-like syndrome and neuropathy. The frequencies of RF, ANA,

anti-SSA/Ro and anti-SSB/La positivities were lower in LORA than in YORA,

whereas elevated erythrocyte sedimentation rates (ESR), C-reactive protein

(CRP) and anemia associated with chronic disease were higher in LORA.

Patients with LORA, according to the accepted international criteria,

present with different clinical and laboratory profiles when compared with

younger patients. These results suggest that age may influence the

presentation of RA at onset.

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