Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort
Comparison of elderly- and young-onset rheumatoid arthritis in an Asian cohort
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DOI：
10.1111/1756-185x.12861
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发表时间：
2017-06-01
影响因子：
2.5
通讯作者：
Koh, Ee-Tzun
中科院分区：
文献类型：
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作者：
Tan, Teck C.;Gao, Xiao;Koh, Ee-Tzun
目的：描述亚洲人群中老年起病(EORA)和青年起病(YORA)类风湿性关节炎(RA)患者的人口学特征、临床特征、功能状态和生活质量。EORA的定义是发病年龄在60岁或以上。结果：队列患者1206例，其中EORA 178例(14.8%)，平均发病年龄66.7+/-5.6岁。EORA组男性多于YORA组(23.0%比14.7%，P=0.005)。EORA患者在症状出现后更早被诊断出来，并且有更多的合并症(中位数2[四分位数范围1-3]对1(0-2)，P<；0.001)。他们不太可能是类风湿因子阳性，有较高的血沉速率值和较低的血红蛋白浓度。两组关节数、28个关节的疾病活动性评分和X线平片的侵蚀发生率均无显著差异。尽管EORA患者的健康评估问卷得分和功能状态低于YORA患者，但他们在简表36的一般健康和心理部分摘要中疼痛得分较低，而得分较高。Eora患者服用抗风湿药物的数量明显减少。结论：Eora和YORA患者具有不同的人口学特征。尽管他们有相似的疾病活动，但埃罗拉患者接受的强化治疗较少。EORA患者有更多与RA相关的并发症和较差的身体功能，但他们在情感和精神上处理得更好。
Objective: To describe the demographic characteristics, clinical features, functional status and quality of life of elderly-onset (EORA) and young-onset (YORA) rheumatoid arthritis (RA) patients in an Asian cohort.Methods: We studied all RA patients in our prospective disease registry, utilizing baseline data. EORA was defined as disease onset at 60 years or older. We collected data from January 2001 to December 2012.Results: There were 1206 patients in our cohort, of which 178 (14.8%) had EORA, with a mean age of onset of 66.7 +/- 5.6 years. There were more males in the EORA than YORA group (23.0% vs. 14.7%, P = 0.005). EORA patients were diagnosed sooner after symptom onset and had a higher number of comorbidities (median 2 [inter- quartile range 1-3] vs. 1 (0-2), P < 0.001). They were less likely to be rheumatoid factor positive, had higher erythrocyte sedimentation rate values and lower hemoglobin concentrations. There was no significant difference in joint counts, Disease Activity Score of 28 joints activity score and prevalence of radiographic erosions. Though EORA patients had worse Health Assessment Questionnaire scores and poorer functional status than YORA ones, they had lower pain scores and higher scores in the general health and mental component summary of the Short Form-36. EORA patients received significantly lower numbers of disease-modifying anti-rheumatic drugs.Conclusions: EORA and YORA patients had different demographic characteristics. Although they had similar disease activities, EORA patients received less intensive treatment. EORA patients had a higher number of RA-related co-morbidities and poorer physical functioning but they coped better emotionally and mentally.