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Health & Medicine for Senior Citizens

Mayo Clinic Researchers Determine Your Lifetime Risk for Rheumatoid Arthritis

Also calculate risk for five other autoimmune rheumatic diseases for women and men - watch video

Jan. 6, 2011 – A popular pastime for many older people is to try and figure out their chances of getting one ailment or another. Mayo Clinic researchers have simplified it – they have figured out the lifetime risk of developing rheumatoid arthritis and six other autoimmune rheumatic diseases for both men and women.

"We estimated the lifetime risk for rheumatic disease for both sexes, something that had not been done before -- separately or collectively," says Cynthia Crowson Mayo Clinic biostatistician and first author.

"Prevalence and incidence rates existed, but prevalence figures underestimate individual risk and incidence rates express only a yearly estimate."

 

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The researchers were looking for an accurate basis to offer an easy-to-understand average risk over a person's lifetime, knowing that risk changes at almost every age.

They used data from the Rochester Epidemiology Project, a long-term epidemiology resource based on patients in Olmsted County, Minn. The cohort of 1179, consisted of patients diagnosed between 1955 and 2007, allowed the team to extrapolate the nationwide estimates.

The adult lifetime risk in the United States of having some kind of inflammatory autoimmune disease is 8.4 percent for women and 5.1 percent for men.

Based on year 2000 population figures, that means one woman in 12 and one man in 20 will develop one of the conditions in their lifetime.

The authors consider that a substantial risk and say their findings should encourage more research on the value of early diagnosis and intervention for people with increased genetic risk of arthritis. They hope the new figures will help in counseling patients and in fundraising efforts to find improved treatments.

The figures below reflect lifetime risk for the respective diseases, based on the Mayo findings.

 Disease 

Women

Men

Rheumatoid Arthritis (RA)

3.6% or 1 in 28

1.7% or 1 in 59

Polymyalgia Rheumatica

2.4%

1.7%

Systemic Lupus Erythematosus

.9%

.2%

Giant Cell Arteritis

1%

.5%

Psoriatic Arthritis

.5%

.6%

Primary Sjögrens syndrome

.8%

.04%

Ankylosing Spondylitis

.1%

.6%


 

The research was supported by the National Institutes of Health.

Other Mayo authors are Eric Matteson, M.D., M.P.H.; Elena Myasoedova, M.D., Ph.D.; Clement Michet, M.D.; Floranne Ernste, M.D.; Kenneth Warrington, M.D.; John Davis III, M.D.; Gene Hunder, M.D.; Terry Therneau, Ph.D.; and Sherine Gabriel, M.D.

About Mayo Clinic (Self-description)

Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit www.mayoclinic.org/about/.


Arthritis Advice for Boomers and Senior Citizens

By National Institute on Aging

The word "arthritis" makes many people think of painful, stiff joints. But, there are many kinds of arthritis, each with different symptoms and treatments. Most types of arthritis are chronic. That means they can go on for a long period of time.

Arthritis can attack joints in almost any part of the body. Some types of arthritis cause changes you can see and feel—swelling, warmth, and redness in your joints. In some kinds of arthritis, the pain and swelling last only a short time, but are very uncomfortable. Other types of arthritis might be less painful, but still slowly cause damage to your joints.

Common Kinds of Arthritis

Arthritis is one of the most common diseases in the United States. Older people most often have osteoarthritis, rheumatoid arthritis, or gout.

Osteoarthritis (OA) is the most common type of arthritis in older people. OA starts when tissue, called cartilage, that pads bones in a joint begins to wear away. When the cartilage has worn away, your bones rub against each other. OA most often happens in your hands, neck, lower back, or the large weight-bearing joints of your body, such as knees and hips.
OA symptoms range from stiffness and mild pain that comes and goes to pain that doesn’t stop, even when you are resting or sleeping.

Sometimes OA causes your joints to feel stiff after you haven’t moved them for awhile, like after riding in the car. The stiffness goes away when you move the joint. Over time, OA can make it hard to move your joints. It can cause a disability if your back, knees, or hips are affected.

Why do you get OA? Growing older is what most often puts you at risk for OA, possibly because your joints and the cartilage around them become less able to recover from stress and damage. Also, OA in the hands may run in families. Or, OA in the knees can be linked with being overweight. Injuries or overuse may cause OA in joints such as knees, hips, or hands.

Rheumatoid arthritis (RA) is an autoimmune disease, a type of illness that makes your body attack itself. RA causes pain, swelling, and stiffness that lasts for hours. RA can happen in many different joints at the same time. People with RA often feel tired or run a fever. RA is more common in women than men.

RA can damage almost any joint. It often happens in the same joint on both sides of your body. RA can also cause problems with your heart, muscles, blood vessels, nervous system, and eyes.

Gout is one of the most painful kinds of arthritis. It most often happens in the big toe, but other joints can also be affected. Swelling may cause the skin to pull tightly around the joint and make the area red or purple and very tender.

Eating foods rich in purines like liver, dried beans, peas, anchovies, or gravy can lead to a gout attack. Using alcohol, being overweight, and taking certain medications may make gout worse. In older people, some blood pressure medicines can also increase the chance of a gout attack. To decide if you have gout, your doctor might do blood tests and x-rays.

Warning Signs

You might have some type of arthritis if you have:

   > Ongoing joint pain

   > Joint swelling

   > Joint stiffness

   > Tenderness or pain when touching a joint

   > Problems using or moving a joint normally

   > Warmth and redness in a joint

If any one of these symptoms lasts more than 2 weeks, see your regular doctor or one who specializes in treating arthritis, called a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor right away.

Treating Arthritis

Getting enough rest, doing the right exercise, eating a healthy, well-balanced diet, and learning the right way to use and protect your joints are keys to living with any kind of arthritis. The right shoes and a cane can help with pain in the feet, knees, and hips when walking. There are also gadgets to help you open jars and bottles or to turn the doorknobs in your house.

Some medicines can help with pain and swelling. Acetaminophen might ease arthritis pain. Some people find NSAIDs (nonsteroidal anti-inflammatory drugs), like ibuprofen, naproxen, and ketoprofen, helpful. Some NSAIDs are sold without a prescription, while others must be prescribed by a doctor.

Be very careful about possible side effects of some NSAIDs, whether sold with or without a prescription. Read the warnings on the package or insert that comes with the drug. Talk to your doctor about if and how you should use acetaminophen or NSAIDs for your arthritis pain. The U.S. Food and Drug Administration has more information about these drugs.

Osteoarthritis (OA). Medicines can help you control the pain. Rest and exercise may make it easier to move your joints. Keeping your weight down is a good idea. If pain from OA is very bad, there are shots your doctor can give you.

Rheumatoid arthritis (RA). Treatment can help the pain and swelling. This might slow down or stop joint damage. You may feel better and find it easier to move around. Your doctor might also suggest anti-rheumatic drugs called DMARDs (disease-modifying antirheumatic drugs). These can slow damage from the disease. Other medicines known as corticosteroids (like prednisone) can ease swelling. Another kind of drug, called a biologic response modifier, blocks the damage done by the immune system. These may help people with mild-to-moderate RA when other treatments have not worked.

Gout. The most common treatment for an acute attack of gout is NSAIDs or glucocorticoids like prednisone. They can bring down the swelling, so you may start to feel better within a few hours after treatment. The pain usually goes away within a few days. Glucocorticoids are strong medicines. They should only be taken with a doctor’s prescription. If you have had an attack of gout, talk to your doctor to learn why you had the attack and how to prevent future attacks. If you have had several attacks, your doctor might prescribe medicines to prevent future ones.

Exercise Can Help

Along with taking the right medicine and properly resting your joints, exercise might help with arthritis symptoms. Daily exercise, such as walking or swimming, helps keep joints moving, lessens pain, and makes muscles around the joints stronger.

Three types of exercise are best if you have arthritis:

   ● Range-of-motion exercises, like dancing, might relieve stiffness, keep you flexible, and help you keep moving your joints.

   ● Strengthening exercises, such as weight training, will keep or add to muscle strength. Strong muscles support and protect your joints.

   ● Aerobic or endurance exercises, like bicycle riding, make your heart and arteries healthier, help prevent weight gain, and also may lessen swelling in some joints.

The National Institute on Aging (NIA) has a free booklet on how to start and stick with a safe exercise program. See the last panel of this AgePage for more information.

Other Things To Do

Along with exercise and weight control, there are other ways to ease the pain around joints. You might find comfort by using a heating pad or a cold pack, soaking in a warm bath, or swimming in a heated pool.

Your doctor may suggest surgery when damage to your joints becomes disabling or when other treatments do not help with pain. Surgeons can repair or replace some joints with artificial (man-made) ones.

Other Remedies

Recent studies suggest that acupuncture may ease OA pain for some people. Research also shows that two dietary supplements, glucosamine and chondroitin, may help lessen moderate to severe OA pain, but they seem to have no effect on changes to cartilage in the knee. Scientists continue to study these kinds of alternative treatments. Always check with your doctor before trying any new treatment for arthritis.

Many people with arthritis try remedies that have not been tested or proven helpful. Some of these, such as snake venom, are harmful. Others, such as copper bracelets, are harmless, but also unproven.

How can you tell that a remedy may be unproven?

   ● The remedy claims that a treatment, like a lotion or cream, works for all types of arthritis and other diseases.

   ● Scientific support comes from only one research study.

   ● The label has no directions for use or warning about side effects.

   ● The person recommending the treatment profits directly from your purchase of the medicine.

   ● People who are now completely well are presented to you as having the same problems you have (this is called anecdotal evidence).

See below for more information about getting NIA’s AgePage called Beware of Health Scams.

Talk To Your Doctor

Pain and arthritis do not have to be part of growing older. You can work with your doctor to safely lessen the pain and stiffness and to prevent more serious damage to your joints.

For More Information

Here are some helpful resources:

American College of Rheumatology/
Association of Rheumatology Health Professionals

1800 Century Place, Suite 250
Atlanta, GA 30345-4300
1-404-633-3777
www.rheumatology.org

Arthritis Foundation
P.O. Box 7669
Atlanta, GA 30357-0669
1-800-283-7800 (toll-free)
or check the telephone directory for your local chapter
www.arthritis.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases
NIAMS Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
1-877-226-4267 (toll-free)
1-301-565-2966 (TTY)
www.niams.nih.gov

National Center for Complementary and Alternative Medicine
NCCAM Clearinghouse
P.O. Box 7923
Gaithersburg, MD 20898
1-888-644-6226 (toll-free)
1-866-464-3615 (TTY/toll-free)
www.nccam.nih.gov

To get the NIA’s exercise guide or Beware of Health Scams or for more information on health and aging, contact:

National Institute on Aging
Information Center

P.O. Box 8057
Gaithersburg, MD 20898-8057
1-800-222-2225 (toll-free)
1-800-222-4225 (TTY/toll-free)
www.nia.nih.gov
www.nia.nih.gov/Espanol

To sign up for regular email alerts about new publications and other information from the NIA, visit www.nia.nih.gov/HealthInformation.

Visit NIHSeniorHealth (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. Special features make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.

National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services

July 2009 Last Update Aug. 6, 2009

>> Click to latest from Institute on Aging


About Arthritis (MedlinePlus)

If you feel pain and stiffness in your body or have trouble moving around, you might have arthritis. Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Over time, a swollen joint can become severely damaged. Some kinds of arthritis can also cause problems in your organs, such as your eyes or skin.

One type of arthritis, osteoarthritis, is often related to aging or to an injury. Other types occur when your immune system, which normally protects your body from infection, attacks your body's own tissues. Rheumatoid arthritis is the most common form of this kind of arthritis. Juvenile rheumatoid arthritis is a form of the disease that happens in children. Infectious arthritis is an infection that has spread from another part of the body to the joint.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

About Rheumatoid Arthritis (MedlinePlus)

Rheumatoid arthritis (RA) is a form of arthritis that causes pain, swelling, stiffness and loss of function in your joints. It can affect any joint but is common in the wrist and fingers. More women than men get rheumatoid arthritis. It often starts between ages 25 and 55. You might have the disease for only a short time, or symptoms might come and go. The severe form can last a lifetime.

Rheumatoid arthritis is different from osteoarthritis, the common arthritis that often comes with older age. RA can affect body parts besides joints, such as your eyes, mouth and lungs. RA is an autoimmune disease, which means the arthritis results from your immune system attacking your body's own tissues.

No one knows what causes rheumatoid arthritis. Genes, environment and hormones might contribute. Treatments include medicine, lifestyle changes and surgery. These can slow or stop joint damage and reduce pain and swelling.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

About Autoimmune Diseases (MedlinePlus)

Your body's immune system protects you from disease and infection. But if you have an autoimmune disease, your immune system attacks healthy cells in your body by mistake. Autoimmune diseases can affect many parts of the body. These diseases tend to run in families. Women - particularly African-American, Hispanic-American, and Native-American women - have a higher risk for some autoimmune diseases.

There are more than 80 types of autoimmune diseases, and some have similar symptoms. This makes it hard for your health care provider to know if you really have one of these diseases, and if so, which one. Getting diagnosed can be frustrating and stressful. In many people, the first symptoms are being tired, muscle aches and low fever.

The diseases may also have flare-ups, when they get worse, and remissions, when they all but disappear. The diseases do not usually go away, but symptoms can be treated.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

 

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