Accelerated Aging Documented in Patients with Arthritis

From the American College of Rheumatology

WASHINGTON, DC—It has been observed in recent years that patients with rheumatoid arthritis (RA) die at a younger age than people without this disease. Now, researchers at the Mayo Clinic have put a number on it. Using a novel mathematical model, they estimate that patients with RA age at approximately 1.25 times the rate of those in the general population. That is, during each 10-year time span, patients with RA age 12.5 years.

This finding comes from a new study presented at the American College of Rheumatology meeting, which relied in part on information gleaned from laboratory scientists, who observed that cells affected by RA begin to show signs of accelerated aging, with resulting damage at the molecular level. It is theorized that RA causes premature aging because of its effects on many physiologic functions, including the immune and the endocrine systems, the muscles, and the nervous system.

This population-based study included 393 seropositive patients with diagnosed RA (mean age, 57 years; 73% women). At a mean follow-up of 15.9 years, 260 patients died (data on age and cause of death were obtained from medical records). The most common causes of death were cardiovascular (97 patients) and respiratory (42 patients) conditions.

These data were compared with expected survival in an age and gender-matched sample from the general population (obtained from the National Center for Health Statistics). Using an accelerated failure time model, the researchers were able to estimate an “acceleration factor” to assess the rate of aging in the patients with RA.

“We’ve known for decades that the mortality rate among people with rheumatoid arthritis is higher, and that these patients are at increased risk for heart and lung disease,” said coinvestigator Sherine E. Gabriel, MD, MSc, William J. and Charles H. Mayo Professor, and chairman, Department of Health Sciences Research, Mayo Clinic, Rochester. “With this study, we’ve now applied a mathematical model that shows consistency between our observed mortality rates and our understanding of the concept of accelerated aging.”

Coinvestigator Cynthia Crowson, MS, commented that this study shows that there appears to be a direct relationship between death at an earlier age in patients with RA and accelerated aging.

“The clinical implications are that a variety of common chronic diseases, such as heart or lung disease, might occur in people with RA at a younger age than you would expect,” Dr Gabriel told IMWR. “Physicians need to start looking for and thinking about these diseases in their RA patients at a younger age. A higher degree of vigilance may be required when it comes to prevention of common, potentially fatal diseases….So, RA patients are a group that may require special attention when it comes to disease prevention.”