The features of rheumatoid arthritis in the patients above the age of 60.
Fifty-seven patients with rheumatoid arthritis (RA), who were divided into 2 groups: below 50 and above the age of 60 with the disease onset at the age of 24 to 81 were analyzed. They were treated in the Clinic for Rheumatology between 1985 and 1995. All the patients fulfilled the American Rheumatism Association (ARA) criteria for RA from 1988. The aim of the study was to reveal any specific qualities of RA with the onset at the age above 60 and to compare them with the specific qualities in younger patients in order to come to certain conclusions useful for diagnosis and the treatment. The investigations revealed significant differences in articular and systemic manifestations in the patients with the late onset of RA. The disease onset was often acute, with monoarthritis of the large joints, high erythrocyte sedimentation rate (ESR), increased level of alkaline phosphatase (ALP), and with slow and incomplete remissions. The effect of nonsteroid anti-inflammatory drugs (NSAID-s) was poorer, followed by more frequent adverse effects in the group of patients above 60 than in the younger patients. The administration of gold and D-penicillamine showed no effect in the elderly, and the cytostatic treatment was not also indicated. The complications and relapses occurred more frequently, and remissions were shorter compared to those in the younger patient group.
Popović
R
R
Military Medical Academy, Clinic for Rheumatology, Belgrade.
Arsić
L
L
Krstić
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies