Expert speak: Rheumatoid arthritis may decrease lifespan of elderly patients

Rheumatoid arthritis is a debilitating disease that can drastically bring down a person’s quality of life. Dr Ravi Gaur, MD (Pathology), COO, Oncquest Laboratories Limited, sheds light on this progressive condition.

By: Editorial Team | Edited by: Jahnavi Sarma | | Updated: November 1, 2019 6:33 pm

Early symptoms of rheumatoid arthritis may go unnoticed but demand immediate intervention. © Shutterstock

Rheumatoid arthritis (RA) is a progressive and disabling autoimmune disease in which the body’s immune system mistakenly attacks the joints. This results in inflammation that causes the tissue that line the inside of joints to thicken. As a result of this thickening, swelling and pain in and around the joints occur. This inflammation, if left unchecked, can damage and even lead to the loss of cartilage, an elastic tissue that covers the ends of bones in a joint. It can also damage the bones. RA usually affects the hands and feet first, but it can attack any joint. It usually involves the same joints on both sides of the body.

Rheumatoid arthritis is a systemic disease, which means it affects the whole body. There is a saying for RA, “It’s a disease which hurt the joints and kills the heart “. It occurs when a person’s immune system mistakes the body’s healthy tissues for foreign invaders. As the immune system responds, inflammation occurs in the target tissue or organ. In the case of RA, this can be the joints, lungs, eyes, and heart.

This disease affects about 0..90 per cent of the adult population in India. It occurs earlier in women than in men. It is difficult to make an exact estimate regarding the number of people suffering from this condition because it goes largely underreported.

Prognosis of rheumatoid arthritis patients

It is not possible to predict the life expectancy of a patient diagnosed with RA accurately due to unpredictable variables. This is a chronic and progressive disease. Healthcare professionals are not very sure as to the exact causes or triggers of the disease. But they believe that it may be due to a combination of factors. Thanks to advancements made in the field of medical science and research, there are now many treatment options that can prolong the lives of patients, slow the progression of disease and provide some relief too.

How does it affect life expectancy?

What research has found is that it isn’t the disease itself which reduces the life expectancy of patients. This happens because of the associated complications. For example, RA can cause respiratory and cardiovascular disorders, which can accumulate over time and lead to a shortened lifespan. This is different than saying that RA itself causes premature death.

The complications that develop (hardened or blocked heart arteries, lung scarring, blood cancers, etc.) as a result of an aggressive RA disease increases a patient’s risk of a lower life expectancy. Generally, patients can expect their longevity to come down by 10 to 15 years. But you must remember that this is dependent on a number of factors including, but not limited to, gender, age, personal and family medical history, lifestyle (past and present), overall health and wellbeing, etc.

Rheumatoid arthritis and women

Women are almost three times more likely than men to develop RA. Symptoms seen in women are also typically more severe. To add insult to injury, the disease is more progressive and can potentially involve more systemic complications.

Symptoms of rheumatoid arthritis

Common symptoms include stiff joints, especially upon getting up in the mornings or after sitting down for a while. Some people often experience fatigue and a general feeling of being unwell. Pain, swelling and stiffness in more than one joint are other symptoms. RA affects the joints of the feet, hand, elbows, wrists, ankles and knees. Pain and inflammation in the small joints for a few weeks, accompanied by morning stiffness that lasts for over 45 minutes to an hour, are also indications of rheumatoid arthritis. This is not a curable condition, but you can prevent it or delay its progress.

Diagnosis of rheumatoid arthritis

Early diagnosis is essential. As we age, degeneration in joints of the body and the resulting joint pain is inevitable. Coupled with osteoarthritis, it can be debilitating. The problem is that most people do not seek treatment till the condition becomes unbearable. Therefore, early diagnosis is very important.

Instead of taking pain medications, consult a doctor. He will ask you to undergo a few blood tests to confirm your condition and prescribe proper medication.

Treatment options

Try to avoid pain killers. You must visit a doctor if you notice any symptoms. He will prescribe specific medicines to manage your condition. If the disease is left unattended, then treatment gets increasingly difficult.

Regular follow-up is also very important in this condition. If you get relief, it doesn’t mean that you stop going to your doctor. Treatment for this disease is an ongoing process. You must also try and avoid trying out multiple conventional and non-conventional treatment procedures. It may adversely affect the outcome.

Early treatment greatly improves the prognosis of RA patients. If treatment begins before symptoms cause too much damage, they can generally go on to live a better (maybe even almost normal) quality of life. Ongoing treatment and monitoring can help doctors to provide the most appropriate and personalised care for their patients.

Each patient will experience a different set of symptoms over their lifetime. Doctors look for warning signs of other complications associated with RA and work to either prevent them or treat them as they develop. The main goal of treatment is to reduce pain and improve quality of life. Many patients experience very effective treatment plans and continue to live their lives making appropriate lifestyle adjustments along the way. In fact, with proper treatment, many RA patients live well into their 80s and 90s which is an average expected lifespan.

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