Life Expectancy and Rheumatoid Arthritis

Rheumatoid Arthritis Complications Can Affect Mortality

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Rheumatoid arthritis (RA) is a debilitating disease with serious physical, emotional, and economic consequences that afflicts about 1 percent of the world's adult population. The prevalence of the disease increases with age and affects two to three times as many women as men.

Regarded most often as a chronic disease rather than a fatal one, rheumatoid arthritis has been shown to decrease a person's life expectancy.

This can vary greatly and is dependent on factors such as other medical conditions, how aggressive treatment is, and the timing of the diagnosis.

The Challenges of RA

In general, people with rheumatoid often face progressive limitations in physical function. If you're still working, the likelihood is that the disability will affect your work within 10 years after the onset of the disease, causing a dramatic reduction in income.

It's also expected that compared to people without RA, those dealing with the disease will incur a number of other challenges. These include higher medical care costs, increased hospitalization, and a greater number of doctor visits.

All of these factors can impact your quality of life, which is a concern for rheumatologists tasked with managing this chronic disease. The physical pain and financial challenges can be daunting and take its toll on one's mental health as well.

However, an early diagnosis, proper treatment, and a good support system can improve your overall well-being, even with RA.

Mortality Risks

As in the general population, the leading cause of death among patients with rheumatoid arthritis is cardiovascular disease and the rate of incidence is comparable.

Patients with rheumatoid arthritis, however, are at greater risk of mortality due to infections, renal disease, respiratory conditions, or gastrointestinal disease.

Excess mortality from infection and from a renal disease are likely indicative of the presence of severe disease. Most of the added mortality from gastrointestinal causes is treatment related.

Renal conditions may lead to kidney damage and there is increasing evidence that this along with rheumatoid arthritis increases the risk for cardiovascular disease. Complications such as vasculitis and amyloidosis and those due to medical treatments like gold salts, penicillamine, and cyclosporine can be problematic as well. 

Life Expectancy

Life expectancy is shorter among patients with rheumatoid arthritis than in the general population. Survival rates are comparable to those for Hodgkin's disease, diabetes mellitus, and three-vessel coronary artery disease.

With regard to reduced life expectancy for rheumatoid arthritis patients, the standardized mortality ratio from different studies has ranged from 1.13 to 2.98. This mainly applies to rheumatoid factor positive cases, although a subgroup of rheumatoid factor negative cases with an adverse long-term prognosis exists.

Clinically based studies probably often overestimate the true shortening of life span and population-based studies may underestimate it. The complexity and duration of RA also make significant study results intermittent, though we do have some notable studies to reference.

Study Results

In 1989, a study was done in Finland of 1666 people who had died and had been receiving medication for RA. Demographic data on the Finnish population and sickness insurance statistics were used as the basis for computations. Results indicated that the life span of subjects with RA was shortened by 15 percent to 20 percent from the date of onset of illness.

  • About 40 percent of the excess deaths were due to cardiovascular causes.
  • About 30 percent were due to infections.
  • About 15 percent were due to amyloidosis.
  • The remaining 15 percent were due to various other causes.

In another long-term study, researchers at the Mayo Clinic studied the impact of RA mortality over 40 years in Olmsted County, Minnesota. People with rheumatoid arthritis who were at least 35-years-old in 1965, 1975, and 1985 were compared. Researchers also examined the records of new cases of rheumatoid arthritis for the 30-year period from 1955 to 1985. 

In 1965 there were 163 existing cases of rheumatoid arthritis in Olmsted County. In 1975 there were 235 cases and in 1985 there were 272 cases. The survival rate was compared to that of people without RA. 

Researchers concluded that the risk of mortality for people with rheumatoid arthritis is approximately 38 percent greater than for the general population. The risk was even greater for women, with a 55 percent increased risk compared to women of the general population.

As an example, a 50-year-old woman with rheumatoid arthritis can expect to live four fewer years (30 more years instead of 34 more years) than a woman without rheumatoid arthritis. However, a 50-year-old man with rheumatoid arthritis can expect to live 26 more years while a 50-year-old man without rheumatoid arthritis can expect to live 27 more years.

A Word From Verywell

It can be concluded that life expectancy is shortened for patients with rheumatoid arthritis. Yet, it has also been proven that treatment of the disease can enhance your quality of life, which may be the more important fact to remember. Generally, the benefits of treatment outweigh the risks.

Working with your doctor, you will discover all the treatment options available. These will take into consideration your family history and overall health so you can get the most out of life with rheumatoid arthritis.

Sources:

Myllykangas-Luosujarvi R, Aho K, Kautiainen H, Isomaki H. Shortening of Life Span and Causes of Excess Mortality in a Population-Based Series of Subjects With Rheumatoid Arthritis. Clinical and Experimental Rheumatology. 1995;13(2):149-53

van Sijl AM, et al. Subclinical Renal Dysfunction Is Independently Associated With Cardiovascular Events in Rheumatoid Arthritis: the Carré Study. Annals of the Rheumatic Diseases. 2012;71(3):341-4.

Gabriel SE, et al. Survival in Rheumatoid Arthritis: A Population-Based Analysis of Trends Over 40 Years. Arthritis & Rheumatism. 2003;48(1):55-58.

Salaffi F, Sarzi-Puttini P, Girolimetti R, Atzeni F, Gasparini S, Grassi W. Health-Related Quality of Life in Fibromyalgia Patients: A Comparison With Rheumatoid Arthritis Patients and the General Population Using the SF-36 Health Survey. Clinical and Experimental Rheumatology. 2009;27:S67-74.

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