Rheumatoid arthritis is the second most common type of arthritis, following osteoarthritis. It is one of the severely debilitating joint disease in seniors. Although it tends to start earlier in life, it is the elderly that tend to suffer the worst complications and most severe forms of associated disability. Rheumatoid arthritis is a chronic disease that affects different organs but mainly involves the small joints of the hands and feet.
Inflammation of the capsule around the joint is the main reason behind the symptoms of rheumatoid arthritis. About 1% of the world’s populations suffer from rheumatoid arthritis and this is across all age groups although it is more common in adults than children. Although not widely known, rheumatoid arthritis is not solely a disease of the joints. The disease can affect other organs like skin, lungs, eyes, kidneys and heart.
The symptoms depend upon the organ involved. The joints are the most commonly affected site in the majority of patients. However, the elderly are more likely to experience involvement of other organs and these symptoms are known as the extra-articular manifestations.
Rheumatoid arthritis is an autoimmune disease that occurs due to improper stimulation of the immune system. In autoimmune diseases, the immune system mistakenly recognizes the body’s own tissue (self proteins) as foreign and starts directing its action against it. In rheumatoid arthritis, it is the synovial membrane which is mainly affected. The synovial membrane that lines the joint cavity is the most commonly affected body part.
In response to inflammation the synovial membrane becomes thick and gradually there is erosion of the bones and adjacent cartilages leading to joint damage and deformity. The exact factors that trigger the immune response are not known. However, certain factors are assumed to be responsible such as genes and infections. This then disrupts the body’s immune responses.
People who are more likely to develop risk factors include :
There is no definitive cure for rheumatoid arthritis. Drugs are effective in managing the condition but do not cure the condition completely. These drugs include anti-inflammatory medications like NSAIDs, steroids, immunosppressants, disease modifying agents and TNF alpha inhibitors. Regular exercise helps improve joint flexibility and stiffness reduction. If drugs fail to halt progression of the disease, surgery is done to improve joint function. The elderly who are more likely to develop complication often need reconstructive joint surgery.