Can rheumatoid arthritis (RA) occur at the age of 66?

From the Guidelines

Yes, rheumatoid arthritis (RA) can definitely occur at age 66. While RA often begins between ages 30-60, it can develop at any age, including in older adults [ 1 ]. When RA begins after age 60, it's sometimes called elderly-onset rheumatoid arthritis (EORA). The symptoms are similar to younger-onset RA, including joint pain, stiffness, swelling, and fatigue, though older adults may experience more sudden onset and more shoulder involvement.

Key Considerations

• The prevalence of rheumatoid arthritis increases considerably with age, affecting approximately 6% of the white population older than 65 years [ 1 ].
• If you're 66 and experiencing persistent joint pain, stiffness (especially in the morning), swelling in multiple joints, or symmetrical joint involvement, you should consult a rheumatologist promptly.
• Early diagnosis and treatment are crucial to prevent joint damage and reduce the risk of comorbid conditions and mortality [ 1 ].

Treatment Approach

• Treatment typically includes medications like methotrexate (starting at 7.5-15mg weekly), hydroxychloroquine (200mg twice daily), or biologics like adalimumab or etanercept if needed [ 1 ].
• These are often combined with low-dose prednisone (5-10mg daily) initially to control inflammation quickly while slower-acting medications take effect.
• RA in older adults requires careful medication management due to potential interactions with other conditions and medications common in this age group [ 1 ].

From the FDA Drug Label

A total of 480 RA patients ages 65 years or older have been studied in clinical trials. The FDA drug label does not directly answer if rheumatoid arthritis (RA) can occur at the age of 66, but it does mention that 480 RA patients ages 65 years or older have been studied in clinical trials 2. This implies that RA can occur in patients older than 65, but it does not provide a specific answer for the age of 66. However, based on this information, it can be inferred that RA can occur at any age, including 66.

From the Research

Rheumatoid Arthritis Occurrence at 66 Years Old

• Rheumatoid arthritis (RA) can occur at any age, including 66 years old, as indicated by the concept of elderly-onset RA, which refers to RA that manifests after the age of 60 3, 4, 5.
• The term elderly onset of rheumatoid arthritis (EORA) describes the disease with onset at age over 60, and several observational studies have shown that the proportion of women and men is comparable in EORA 5.
• Studies have compared the clinical manifestations and treatment patterns of RA in patients who developed the disease at different ages, including those over 60, and found that EORA patients may have a different clinical course and treatment approach compared to younger patients 6.
• The management of RA in elderly patients can be challenging due to comorbidities and increased frequency of adverse events, and requires special consideration and a tailored approach 3, 4, 7.

Key Findings

• Up to one-third of RA patients first present for treatment after the age of 60 years (elderly-onset RA) 4.
• The overall frequency of RA in individuals older than 65 is increased, with 30 to 40% of RA patients treated in rheumatology centers being over 60 years of age 4.
• EORA patients may have a more advanced destructive changes of joints and functional impairment compared to younger onset RA patients 5.
• The use of methotrexate and biological drugs is less common in EORA patients, while glucocorticosteroids are more common 5, 6.