Rheumatoid arthritis in the elderly: is it a different disease?

Controversy has surrounded the question of whether rheumatoid arthritis (RA) afflicting the elderly is a different disease than RA in younger patients. Resolution of this complex question requires careful consideration of the pathogenesis of the disease and its diagnosis and prognosis. Meaningful analysis of these factors optimally derives from a critical review of all relevant medical literature (i.e., an evidence-based approach); however, methodologic inconsistencies and other difficulties with the literature on this subject largely preclude definitive interpretation. This review examines the evidence concerning various aspects of RA in the elderly population.