A clinical study of older age rheumatoid arthritis with comparison to a younger onset group.

The clinical features, therapy and course of disease in a group of 34 patients with older age onset rheumatoid arthritis (ORA) defined as disease onset after age 60 are compared with a group of 34 rheumatoid patients whose disease onset began at a younger age (YRA). Onset of rheumatoid arthritis (RA) beyond age 60 is not uncommon as ORA represented 33% of all RA patients seen in our rheumatic disease unit. The ORA patients had a shorter mean disease duration (p less than 0.001) and a tendency to less rheumatoid factor seropositivity (p = 0.06) despite random selection for active disease of less than 10 years' duration. Suppressive therapy was employed less frequently in ORA (p less than 0.01) than in YRA but the use of other therapeutic modalities and the last recorded functional class were similar in the 2 groups. ORA patients did have greater functional incapacity at some point in their disease course (p less than 0.01) as well as a greater frequency of weight loss (p less than 0.001) and other acute systemic features at onset than YRA patients. Seronegative ORA appeared to have a favourable disease course in comparison with seropositive ORA.