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A Guide To Recognizing Rheumatoid Arthritis In The Elderly

You might be surprised to learn that people of any age can get rheumatoid arthritis, even very young children. The rate of rheumatoid arthritis in the elderly is much higher than in earlier years, which is why we tend to connect the disease with older ages.

On a positive note, rheumatoid arthritis in the elderly is so common that researchers have performed numerous studies on it.

We’ve learned helpful information from their studies about the symptoms and treatments that can help seniors and others who live with rheumatoid arthritis perform their daily activities and enjoy life with less pain.

We will cover in this article:

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What are Some of the Statistics About Rheumatoid Arthritis?

Rheumatoid arthritis is a chronic disease, which means that there is no known cure. It’s an autoimmune disease where antibodies attack the fluid in the synovial joints, which causes inflammation in the joints.

Here are some other things we’ve learned about rheumatoid arthritis in the elderly [i]:

  • It affects over 1.3 million Americans and about 1% of the global population.
  • It’s the most common autoimmune disorder.
  • It’s more common that psoriasis and lupus.
  • Younger women are about 3 times more likely to get rheumatoid arthritis than men.
  • Women are more likely to get rheumatoid arthritis at earlier ages than men.
  • Some experts believe there is a link between female hormones and the disease.
  • It can affect people starting around the age of 30.
  • It more commonly effects people when they reach the senior years, around the age of about 60.
  • It can be genetic.
  • Environmental factors may trigger or worsen the disease.
  • Smoking is a known risk factor for the disease.

Are There Any Early Warning Signs of Rheumatoid Arthritis in the Elderly?

Someone can have early signs of rheumatoid arthritis [ii] and not be aware of it because the symptoms are usually mild at first, causing someone to believe that they’re having run-of-the-mill aches and pains.

Symptoms often occur infrequently, so they’re easy to pass off as nothing or as a symptom of another illness.

Early signs include:

  • Noticeable symptoms in just one joint like the ankle, shoulder, wrist, knee, neck or toes
  • Swelling in the joints of one or more fingers
  • Flu-like symptoms, fever, fatigue
  • Small, tender areas under the elbow
  • Stiffness lasting over four hours in the wrist or elbow joints
  • Joint pain that is worse in the morning
  • Reduced range of motion
  • Diagnosing and treating the disease early can help reduce painful symptoms and prevent rheumatoid arthritis in the elderly from progressing.

    Which Joints Do Rheumatoid Arthritis Affect?

    People with rheumatoid arthritis can experience symptoms all over their bodies. Most people notice pain in the joints before they can connect other symptoms to rheumatoid arthritis.

    Joint pain ranges from mild to debilitating. Certain joints tend to be more prone to rheumatoid arthritis than others.

    The most common joints affected are:

    • Knuckles
    • Wrists
    • Shoulders
    • Elbows
    • Feet
    • Toes
    • Knees
    • Ankles
    • Groin

    Medications and other treatments can help manage the pain. Left untreated, rheumatoid arthritis can create permanent damage to bones and joints. It can also affect other areas of the body.

    Are There Noticeable Symptoms of Rheumatoid Arthritis in Other Parts or Symptoms of the Body?

    Rheumatoid arthritis can cause symptoms in many other parts of the body [iii]. As our bodies age, many bodily systems don’t work well, which makes it difficult to discern the difference between symptoms that stem from rheumatoid arthritis and those that stem from general aging.


    Here’s what to look for beyond the joint areas:

    • Thinning bones-bones become thinner and more brittle.
    • Inflammation of the eyes-the whites of the eyes become inflamed causing pain, redness, blurred
    • vision and sensitivity to light. This symptom can cause scarring and lead to blindness.
    • Dryness of the eyes-rheumatoid arthritis can damage the tear-producing glands causing a sense of dryness or grittiness.
    • Mouth dryness-inflammation can damage the glands that produce moisture in the mouth.
    • Inflammation of the lungs-about 80% of people with rheumatoid arthritis have some symptoms in the lungs, though they are often mild. Lung inflammation can cause scarring and lead to pulmonary fibrosis.
    • Rashes-blood vessels become inflamed causing a small rash of red dots or larger skin ulcers on the legs or under nails. Inflammation of the blood vessels can also cause cholesterol build-up in the blood vessels which is known as atherosclerosis.
    • Heart attack or stroke-plaques from damaged blood vessels can detach and float through the blood vessels, block a vessel stopping blood flow to the heart, and cause heart attack or stroke.
    • Inflammation can also cause swelling in the heart lining which is called pericarditis.
    • Blood anemia-inflammation can reduce red blood cells causing headaches and fatigue. It can also lead to blood clotting due to higher blood platelet levels.
    • Pinched or compressed nerves-inflammation of the tissues can cause compression on the nerves resulting in numbness, tingling, or reduced strength.

    It’s important to note that some of the medications that relieve symptoms of rheumatoid arthritis can cause problems with the liver or kidneys and may increase the risk of tuberculosis.

    Is Rheumatoid Arthritis in the Elderly a Different Disease?

    Rheumatoid arthritis is the same disease in elderly people as in young people. While the disease manifests the same at any age, there are some distinct differences in the prevalence of the disease, severity of the symptoms, and rate of progression in people over 60 [iv].

    Note the differences that accompany aging:

    • In older-onset rheumatoid arthritis the gender ratio moves from a 3:1 women-to-men ratio to a 1:1 ratio.
    • Symptoms are gradual in younger years, but manifest suddenly and acutely in later years.
    • In older-onset rheumatoid arthritis, it’s more common for large, proximal joints like shoulders to be affected.
    • Elderly people with rheumatoid arthritis experience greater inflammation and have more symptoms than younger people.
    • Rheumatoid arthritis in the elderly has worse outcomes because their bodies have less ability to repair themselves.

    Several factors contribute to the age that someone becomes affected by rheumatoid arthritis including genetics, hormonal levels, and the strength of their immune system.

    These issues also affect how an aging person’s body responds to the effects of rheumatoid arthritis. People are living longer than in past generations, so treating rheumatoid arthritis is a common medical concern in seniors.

    Diagnosing Rheumatoid Arthritis in the Elderly

    A primary care physician will quickly recognize the symptoms of rheumatoid arthritis. The doctor may refer the individual to a rheumatologist who has special training to diagnose and treat rheumatoid arthritis.

    There is no single test for rheumatoid arthritis, so a rheumatologist administers several tests [v] to be sure.

    • Medical history including personal and family medical history and current symptoms
    • Physical examination for tenderness, swelling, pain and warmth around joints
    • Inspection for rheumatoid nodules
    • Detection of a low-grade fever
    • Blood tests measure the level of inflammation and detect antibodies linked with rheumatoid arthritis
    • Inflammation-Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels are markers of inflammation. Inflammation combined with other health factors may indicate rheumatoid arthritis
    • Certain antibodies like RF, anti-CCP
    • Imaging tests like x-rays, ultrasound, MRI can check for joint damage and erosions

    What are the Causes of Rheumatoid Arthritis in the Elderly?

    Rheumatoid arthritis is an idiopathic disease, which means we don’t know the exact cause of the disease.

    As far as we can tell from the research we have, potential causes [vi] of rheumatoid arthritis fall into four categories—genetics, environment, hormones, and lifestyle.

    Here’s what we know about each of them:

    1. Genetics

    • Rheumatoid arthritis can be heredity, but it isn’t an automatic indicator for the disease.
    • Individuals having a first-degree family member that has a diagnosis of rheumatoid arthritis have about a four times greater risk of developing the disease.
    • Some people with no known family history of rheumatoid arthritis develop it.

    2. Environment

    • Environmental risks can trigger the disease.
    • Pollution, chemicals, secondhand smoke, viruses, insecticides, occupational exposure. and bacteria may be responsible for triggering symptoms of the disease.
    • Experiencing traumatic events may weaken the immune system and trigger symptoms.

    3. Hormones

    • There may be a link between hormones in women and rheumatoid arthritis.
    • As estrogen and progesterone decrease with age, hormones may trigger symptoms.
    • Women who have never given birth may be more susceptible to the disease.
    • 4. Lifestyle

      • Smoking is one of the biggest risk factors in lifestyle that’s connected with rheumatoid arthritis and it can increase the risk of the disease by 2.4%.
      • Smoking may progress the disease faster and make individuals more uncomfortable.
      • Obesity is another factor in increasing symptoms of rheumatoid arthritis and weight loss may reduce the onset or symptoms of the disease.
      • Poor dental hygiene may contribute to the symptoms of the disease as links show some connection to periodontal disease and rheumatoid arthritis.

      What are the Goals of Treatment for Rheumatoid Arthritis in the Elderly?

      Since there is no cure for rheumatoid arthritis, the goals for treatment [vii] focus heavily on making the individual feel less pain, making them more comfortable, and reducing the short and long-term effects of the disease.

      The goals of treatment are:

      • To stop the inflammation
      • Provide relief from symptoms
      • Prevent damage to the joints
      • Protect organs from damage
      • Improve gross and fine motor skills
      • Provide for greater overall functioning and well-being
      • Prevent long-term complications
      • Elongate life span

      Doctors may use terms like disease activity and remission when talking about achieving goals for rheumatoid arthritis.

      Their ultimate goal for patients is to have minimal or no signs of active inflammation. Having tight control of the disease means keeping inflammation at the lowest possible level.

      What are the Treatments for Rheumatoid Arthritis in the Elderly?

      There are several medications and other treatments that can help reduce the symptoms of rheumatoid arthritis. As a word of precaution, some treatments may have side effects that cause complications with medications for other health disorders. With the right treatment, many people live with reduced pain. It is also comment to suffer of insomnia due to the pain of the arthritis.

      Which Medications are Helpful to Reduce Symptoms of Rheumatoid Arthritis?

      It’s best to consult a physician or rheumatologist when considering taking medications for rheumatoid arthritis [vii].

      Some medications work to reduce the symptoms of the disease, while others slow it down to prevent extensive damage. Medications are available by prescription and over-the-counter.

      Medications that ease symptoms include:

      Nonsteroidal anti-inflammatory drugs (NSAIDS)

      These medications are also known as ibuprofen, ketoprofen, naproxen sodium, and others. These medications are available without prescriptions at local drug stores and pharmacies. Some NSAIDS are also available by prescription.

      COX-2 inhibitors

      This group of medications are available in tablet, patches, and creams. They work well for people who have or are at risk of having stomach ulcers, as NSAIDS can cause stomach irritation. Seniors can rub COX-2 inhibitor creams, such as celecoxib, directly to their swollen joints.

      COX-2 inhibitors

      Certain other medications work to slow the activity of the disease.

      These drugs include:

      Corticosteroids

      These medications are strong and fast-acting to reduce inflammation. Physicians often prescribe corticosteroids along with NSAIDS to get inflammation under control while waiting for NSAIDS to work.

      Most physicians prefer to prescribe these medications in low doses and for limited periods of time due to the seriousness of side-effects. Common corticosteroids include prednisone, prednisolone, and methylprednisolone.

      DMARDs

      This stands for disease-modifying antirheumatic drugs. These drugs work to slow the disease down. They can be taken by mouth, self-injections, of infusion at a doctor’s office or hospital. DMARDs that doctors commonly prescribe are methotrexate, azathioprine hydroxycholorquine, leflunomide, sulfasalazine, and cyclophosphamide.

      Biologics

      These medications are in the DMARD family. Physicians may choose this medication because it tends to work faster than DMARDs. Patients can self-inject the medication or receive an infusion in a doctor’s office.
      Biologics target certain phases of inflammation, so they can sometimes slow, modify, or stop the disease better than other medications. Biologics are also less harsh on an individual’s immune system than some other medications.

      JAK inhibitors

      These medications also fall into the DMARD family. They were developed to block the path of Janus kinase (JAK), which work to prevent antibodies from attacking synovial fluid. Tofacitinib is a common JAK inhibitor and patients can take it in tablet form by mouth.

      Early detection and intervention play a vital role in treating rheumatoid arthritis. Getting the right treatment can help seniors enjoy a higher quality of life in the final season of their lives.

      Can Surgery be Considered a Viable Treatment Option for Rheumatoid Arthritis?

      Most people can live a comfortable life by avoiding the issues that contribute to the disease and taking medications to relieve the symptoms.

      For those who have permanent damage to their joints that limits their daily activities, mobility, and independence, surgery [viii] may be a viable option.

      Common joint replacement surgeries are performed on:

      • Hips
      • Knees
      • Ankles
      • Shoulders
      • Wrists
      • Elbows
      • Thumbs
      • Hands

      Joint replacement surgery entails a surgical procedure where surgeons replace damaged parts of a joint with plastic or metal parts.

      Most people tolerate the surgery well and find that it helps restore mobility and relieve pain.

      Are There Any Holistic or Alternative Treatments for Rheumatoid Arthritis?

      In addition to traditional medical treatments, there are some good alternative treatments that may help reduce the symptoms of rheumatoid arthritis.

      It’s best to keep up with doctor-prescribed treatments and get a doctor’s advice on trying anything new.

      Here are some alternative methods [ix] of treatment:

      • Apply an ice-pack to the affected area
      • Apply a moist heating pad to the affected joint
      • Magnet therapies with bracelets, necklaces, inserts, pads, or disks
      • Mind/body therapies such as deep breathing and relaxation techniques
      • Tai Chi is a martial art with slow, dancelike movements
      • Acupuncture is a procedure where a technician inserts super-fine needles into the body to restore energy imbalances
      • Visualization is a method of taking your mind to a calm, peaceful place
      • Biofeedback is a process where sensors placed on the body send messages back to a monitor and the therapist uses the feedback to teach a person how to calm themselves
      • Some people find relief by using natural supplements like fish oil or thunder god oil

      It’s important to note that while health supplements can be helpful, they can have harmful side-effects just like prescription medications.

      How Can an In-Home Caregiver Help an Elderly Person with Rheumatoid Arthritis?

      In-home caregivers can provide assistance for people suffering from rheumatoid arthritis in a variety of ways.

      A caregiver may help by exploring additional treatment options including medical treatments and holistic or alternative treatments. A caregiver might also participate in some activities with the client like doing deep breathing, visualization, or relaxations techniques.

      Caregivers may be needed to help with mobility assistance or help apply hot or cold compresses to aching joints.

      Caregivers are often helpful in communicating a client’s needs to other healthcare professionals like doctors and nurses.

      Most of all, in-home caregivers can provide much-needed empathy and support for seniors who live with chronic or debilitating pain.

      Some Final Thoughts on Rheumatoid Arthritis in the Elderly

      Learning that rheumatoid arthritis is incurable and progressive can be difficult news for seniors and their family members to take initially.

      It’s important to remember that this disease isn’t life-threatening and there are many treatments available to help seniors feel comfortable and without chronic pain. Most people living with rheumatoid arthritis continue to enjoy a good quality of life. It is also important to be aware that seniors are more likely suffer form these kind of conditions among others such as Parkinson, Cerebral Palsy, Als and others.

      Sources

      [i} https://www.rheumatoidarthritis.org/ra/facts-and-statistics/

      [ii] http://www.healthtalk.org/young-peoples-experiences/arthritis/what-arthritis-and-what-are-early-symptoms#ixzz58n2hJALa

      [iii] https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/articles/rhemuatoid-arthritis-affects-body.php

      [iv] http://www.rheumatic.theclinics.com/article/S0889-857X(05)70154-X/fulltext

      [v] https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/diagnosing.php

      [vi] https://www.arthritis-health.com/blog/4-most-likely-causes-rheumatoid-arthritis

      [vii] https://www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php

      [viii] https://www.arthritis.org/living-with-arthritis/treatments/joint-surgery/types/

      [ix] https://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-natural-treatments#1