title: Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort.
abstract: OBJECTIVE
  To describe the demographic characteristics, clinical features, functional status and quality of life of elderly-onset (EORA) and young-onset (YORA) rheumatoid arthritis (RA) patients in an Asian cohort.
  
  
  METHODS
  We studied all RA patients in our prospective disease registry, utilizing baseline data. EORA was defined as disease onset at 60 years or older. We collected data from January 2001 to December 2012.
  
  
  RESULTS
  There were 1206 patients in our cohort, of which 178 (14.8%) had EORA, with a mean age of onset of 66.7 ± 5.6 years. There were more males in the EORA than YORA group (23.0% vs. 14.7%, P = 0.005). EORA patients were diagnosed sooner after symptom onset and had a higher number of comorbidities (median 2 [inter-quartile range 1-3] vs. 1 (0-2), P < 0.001). They were less likely to be rheumatoid factor positive, had higher erythrocyte sedimentation rate values and lower hemoglobin concentrations. There was no significant difference in joint counts, Disease Activity Score of 28 joints activity score and prevalence of radiographic erosions. Though EORA patients had worse Health Assessment Questionnaire scores and poorer functional status than YORA ones, they had lower pain scores and higher scores in the general health and mental component summary of the Short Form-36. EORA patients received significantly lower numbers of disease-modifying anti-rheumatic drugs.
  
  
  CONCLUSIONS
  EORA and YORA patients had different demographic characteristics. Although they had similar disease activities, EORA patients received less intensive treatment. EORA patients had a higher number of RA-related co-morbidities and poorer physical functioning but they coped better emotionally and mentally.
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Teck C
authors.initials: TC
authors.lastname: Tan
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Xiao
authors.initials: X
authors.lastname: Gao
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Bernard Y-H
authors.initials: BY
authors.lastname: Thong
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Khai P
authors.initials: KP
authors.lastname: Leong
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Tsui Y
authors.initials: TY
authors.lastname: Lian
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Weng G
authors.initials: WG
authors.lastname: Law
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Kok O
authors.initials: KO
authors.lastname: Kong
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Hwee S
authors.initials: HS
authors.lastname: Howe
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Hiok H
authors.initials: HH
authors.lastname: Chng
authors.affiliation: Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore, Singapore.
authors.forename: Ee-Tzun
authors.initials: ET
authors.lastname: Koh
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017668:Age of Onset; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology; D044466:Asian People / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000208:ethnology; D008875:Middle Aged; D011788:Quality of Life; D012042:Registries; D012846:Singapore / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents
keywords: Asia; age of onset; disease modifying anti-rheumatic drugs (DMARDs); late-onset disorders; quality of life; questionnaires; rheumatoid arthritis