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Rheumatology Advance Access originally published online on August 3, 2009
Rheumatology 2009 48(10):1261-1264; doi:10.1093/rheumatology/kep195
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Geriatric syndromes in elderly patients with rheumatoid arthritis

Yi-Ming Chen1,2,3, Liang-Kung Chen3,4,5, Jong-Liang Lan1,2,3,6 and Der-Yuan Chen1,2,3,6

1Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, 2Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, 3National Yang-Ming University, 4Center for Geriatrics and Gerontology, 5Department of Family Medicine, Taipei Veterans General Hospital and 6National Chung-Hsing University, Taichung, Taiwan.

Correspondence to: Der-Yuan Chen, Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, No. 160, Section 3, Taichung-Kang Road, Taichung City, 40705, Taiwan. E-mail: dychen{at}vghtc.gov.tw


  Abstract

Objective. Geriatric syndromes (GSs), i.e. cognitive impairment, depression, fall, incontinence and malnutrition, are extensively used to highlight the unique features of common health problems in the frail elderly. Although GS is common in older RA patients, it is rarely reported earlier. We evaluate the prevalence of GS in elderly RA patients and explore the interrelationship between GS and RA.

Methods. All enrolled RA patients were categorized into elderly RA (aged >=65 years) and younger RA (aged <65 years). A comprehensive geriatric assessment was done to determine the presence of GS. HAQ score and disease activity of RA, including 28-joint disease activity score (DAS28), were assessed.

Results. In total, 65 elderly and 25 younger RA patients were enrolled. The prevalence of GS in the elderly participants, especially cognitive impairment and fall, was significantly higher than that in the young. Older RA patients were more physically dependent than the young. Compared with subjects without GS, older RA patients with GS had longer disease duration, higher DAS28 scores, lower haemoglobin levels and more physical dependence. By using binary logistic regression, we found that a higher DAS28 score and a lower haemoglobin level were independent risk factors for GS.

Conclusions. The prevalence of GS was higher in the elderly RA patients than that in the young. A higher DAS28 score and a lower haemoglobin level were independent risk factors for GS in older RA patients. Further study is needed to evaluate the prognostic role of GS.

KEY WORDS: Geriatric syndromes, Rheumatoid arthritis, Disability, Disease activity, Elderly

Submitted 30 January 2009; revised version accepted 8 June 2009.
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