Treating Fatigue in Rheumatoid Arthritis: Does Patient Age Matter?

Clinically relevant fatigue is common in patients with rheumatoid arthritis (RA) and might be expected to be related to patient age and disease severity. This review provides a brief introduction to fatigue as a patient-reported outcome that contributes significantly to burden of disease, with a focus on the evidence in elderly patients, and gives an overview of our current understanding of the factors that contribute to fatigue. We summarize the evidence for the effects of pharmacological (disease-modifying anti-rheumatic drugs, DMARDs) and non-pharmacological interventions for fatigue. The underlying pathophysiology of fatigue is complex and often multifactorial. The experience of fatigue varies between individuals, and subtypes of fatigue are increasingly being recognized. Fatigue can therefore be challenging to recognize and quantify. Recent systematic reviews have shown that fatigue can be improved as a result of treatment with traditional and biological anti-rheumatic drugs, and also with non-pharmacological approaches (physical activity, psychosocial interventions). Age does not appear to be of major importance for fatigue in RA, and similar strategies for treating fatigue apply to all age groups, including the elderly.