Rheumatoid arthritis is a chronic autoimmune condition, that poses serious health challenges. However, patient outcomes have improved over the last several years.
This piece explores the connection between rheumatoid arthritis and life expectancy. We’ll look at the latest research and highlight the factors that affect how long people live. We’ll learn about the challenges ahead and discover ways that people can live a long life with rheumatoid arthritis.
Is it possible to have a long life with rheumatoid arthritis?
Many people with rheumatoid arthritis (RA) can live a long and fulfilling life, especially with early diagnosis and proper treatment. While severe or poorly managed RA may slightly reduce life expectancy due to complications like cardiovascular disease or infections, modern therapies, such as DMARDs and biologics, have significantly improved long term outcomes.
Maintaining a healthy lifestyle, including regular exercise, an anti-inflammatory diet and avoiding smoking, also plays a crucial role in reducing risks. With consistent medical care and proactive self management, most individuals with RA can enjoy a high quality of life and normal lifespan.
What is rheumatoid arthritis and how does it affect the body
Rheumatoid arthritis does more damage than just causing joint pain. The nature of this systemic disease plays a vital role in how it affects longevity and quality of life.
RA as a systemic autoimmune disease
RA develops when the immune system attacks healthy cells in the body. The main target is the synovium, the lining of membranes around joints. This immune system malfunction creates ongoing inflammation that damages bones, cartilage and other joint structures.
The immune system starts attacking the body years before symptoms appear. It often begins in areas outside the joints before settling into joint tissues. The inflamed synovium grows thicker and moves deeper into the joint as the disease progresses. This destroys cartilage and bone. Many patients develop joint deformities and lose function when the condition isn’t treated properly.
RA differs from osteoarthritis, which affects individual joints from wear and tear. It usually appears symmetrically, the same joints on both sides of the body show symptoms. Joint symptoms typically develop slowly in three ways: they stay constant, go away completely or alternate between flares and remission.
Organs and systems commonly affected beyond joints
Joint inflammation stands out as RA’s most visible sign, but the disease affects many body systems. Studies show that up to 80% of people with RA show some lung problems. These range from mild inflammation to serious conditions like interstitial lung disease and pulmonary hypertension.
The cardiovascular system faces big risks too. Long term inflammation hurts the endothelial cells that line blood vessels. These cells absorb more cholesterol and form plaques. This damage makes heart attacks and strokes more likely over time. People with RA face higher risks of cardiovascular problems, including coronary artery disease, heart failure and peripheral artery disease.
Other affected systems include:
- Blood and immune system: low red blood cell counts lead to anemia. The weakened immune system makes infections more common;
- Skin and subcutaneous tissue: rheumatoid nodules, firm lumps under the skin, often form near affected joints. These range from pea-sized to ping pong ball-sized lumps;
- Eyes: inflammation causes redness, pain, vision problems and conditions like keratoconjunctivitis sicca (dry eyes);
- Nervous system: problems include cognitive issues, behavior changes, spinal cord compression and nerve damage;
- Gastrointestinal system: RA patients have more GI problems than others;
- Kidneys: some RA cases show kidney involvement, most often as glomerulonephritis, kidney inflammation.
The disease can also cause bone loss leading to osteoporosis, weak muscles around affected joints and severe fatigue that affects daily life. Some RA medications might affect organs like the liver.
RA’s effects throughout the body show why early diagnosis and detailed treatment matter. These steps help preserve joint function and extend life expectancy. Understanding these widespread effects explains why doctors need to look beyond joint symptoms and treat inflammation throughout the body.
How rheumatoid arthritis impacts life expectancy
Life expectancy for people with rheumatoid arthritis has changed a lot in recent decades. Better treatments exist now, but research shows RA still affects how long people live.
Findings from long term cohort studies
Research over many years shows that people with rheumatoid arthritis die at rates 1.5 times higher than others. This trend hasn’t changed much in 50 years, though things are getting better. A complete 15-year study showed RA patients had a 54% higher death risk compared to others. Later, a 20-year follow up found the death rate at 1.49, which means a 94% relative survival rate.
The effect on lifespan varies quite a bit. Some studies show that RA cuts life expectancy by about 10 years, while others point to smaller reductions. A 20-year study showed just a 0.27-year difference, which equals about 4 months.
Role of respiratory and cardiovascular complications
Specific organ problems cause most deaths in RA patients. Heart disease accounts for a significant portion of mortality in rheumatoid arthritis, likely due to accelerated atherosclerosis. Heart attack risk doubles and stroke risk goes up by 50%, according to studies.
Research show that lung problems rank second in causing deaths. These account for 10-20% of RA patient deaths, mainly due to interstitial lung disease (ILD). RA patients face eight times the risk of lung disease compared to others. Those with RA-ILD die three times more often than those without it. One study found patients with ILD lived only 2.6 years compared to 10 years for RA patients without lung problems.
Beyond heart and lung issues, infections (especially pneumonia), digestive system diseases and muscle and bone complications cause more deaths. Risk factors like being male, older age at diagnosis, reduced lung capacity and certain ILD patterns predict higher death risks.
Key factors that influence longevity in RA patients
Life expectancy for people with rheumatoid arthritis depends on many factors. Patients and doctors can make better decisions about treatments and lifestyle changes by understanding these variables.
Age at diagnosis and sex differences
The age when rheumatoid arthritis first develops can affect long term outcomes. Patients diagnosed with RA at a younger age might see their life expectancy drop by a lot. Young adults often get more severe symptoms that can lead to more damage as time goes on.
Studies show that sex plays a vital role in how the disease shows up and affects survival rates. Women get RA more than men with a ratio of 3:1, but survival patterns differ between sexes. Women with RA live 1-2 years longer than men who have the same condition.
Disease activity and inflammation levels
High disease activity that doesn’t go away is one of the strongest signs of reduced lifespan. High inflammation over time directly cuts life expectancy. Then, patients who manage to keep their disease under control have much better long term outcomes.
Some disease features linked to shorter survival include positive rheumatoid factor, rheumatoid nodules and high inflammation markers. Note that seropositive RA (with rheumatoid factor or anti-CCP antibodies) relates to higher risk of serious lung problems.
Impact of smoking and obesity
Smoking makes a huge difference in how RA develops and progresses. Smokers get more aggressive disease, more lung inflammation and their treatments don’t work as well. Smoking cuts life expectancy by about 10 years, so quitting before age 40 helps a lot, according to studies.
Extra weight makes treatments less effective too. Smoking and excess weight together create the worst outcomes, one study found women who were both obese and smokers had the lowest remission rates, while men at healthy weights who didn’t smoke did the best.
Getting diagnosed early and starting complete treatment from a rheumatologist improves our chances of living longer.
Our long-term health with RA depends on several key factors. Quick diagnosis and immediate treatment are vital steps to prevent joint damage and control inflammation. It also helps to make lifestyle changes, eating anti-inflammatory foods, staying active and taking care of our mental health can add years to our life.
