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Healthy Aging With Rheumatoid Arthritis

Medically Reviewed by Jennifer Robinson, MD on April 11, 2022

Rheumatoid arthritis (RA) can bring on challenges as you get older. There’s a greater chance of falls, along with other health problems, like heart disease and diabetes. And if you’re not able to leave the house or you live far from friends and family, you may feel isolated and alone. These issues are common for many older adults – even more so for those with RA. But there are things you can do to avoid them and stay as healthy as possible later in life.

How Does RA Affect Aging?

In RA, inflammation is systemic. That means it can cause problems throughout your body. About 40% of people with RA have these issues. They’re more likely if your symptoms are severe or you’ve had RA a long time. You should get regular checkups for heart disease, osteoporosis, and other health problems that occur outside your joints.

RA can lead to problems with your:

Heart. People with RA are twice as likely to have a heart attack and 50% more likely to die from heart disease than people without RA. Over time, Inflammation can lead to arrhythmia, an irregular heartbeat, or heart failure. That’s when the heart doesn’t pump as well as it should.

Lungs. Up to 80% of people with RA have lung problems. They’re the second leading cause of death in RA patients. Inflammation can strike any part of your lungs, including the tiny alveoli where the lungs and blood exchange oxygen and carbon dioxide. Disease-modifying antirheumatic drugs (DMARDs) and high doses of tumor necrosis factor (TNF) blockers can lead to lung infections.

Brain. Some studies have found a link between inflammation in RA and Alzheimer’s disease and vascular dementia.

Bones. Osteoporosis – fragile bones more likely to fracture – is a serious side effect of prednisone and other steroid medications you may take for your RA. This is especially true for older folks whose bones are often fragile to begin with. If your doctor prescribes a steroid, ask if you can try a different medicine. Or use the lowest dose of steroids for the shortest time possible. Add calcium and vitamin D supplements to help protect your bones.

Rheumatoid Arthritis and Falls

As you age, you start to lose muscle mass and strength. This is a process called sarcopenia. It may make it hard for you to keep your balance and stay upright. And the inflammation RA triggers doesn’t help. It can speed things up, making you even more likely to fall. Not all falls are serious, but some can cause head trauma or broken bones.

A broken hip is one of the most serious fall injuries in older adults. It can lead to a long hospital stay and make it harder to function or live on your own. You might also decide to do less because you’re afraid of falling again. This can weaken muscles even more and lead to another fall. Other things that can lead to falls as you age include:

To ward off falls:

  • Try an exercise like tai chi to improve leg strength and balance.
  • Ask your doctor about vitamin D supplements to strengthen bones and ease RA inflammation in people with RA.
  • Work with your doctor to control joint pain and swelling.
  • Review the side effects of your medications with your doctor or pharmacist, and ask if some can be stopped or switched.
  • Get your eyes checked at least once a year, and keep eyeglass and contact lens prescriptions up to date.

Around your house:

  • Get rid of clutter.
  • Put grab bars in your shower and railings on your stairs.
  • Use non-skid rugs.

You can also look for fall prevention programs at a local hospital or community center.

How to Get and Stay Healthy with Rheumatoid Arthritis

The inflammation that RA triggers nearly doubles your chance of heart disease and diabetes. It can damage the coronary arteries that send blood to your heart and is a key factor in type 2 diabetes.

Your odds of getting these conditions are even greater if you:

You can manage these risks with these lifestyle changes:

Don’t smoke. This may be the single best thing you can do for your health. Tobacco smoke harms your heart and makes RA worse by sparking inflammation and citrullination. That’s the process in which autoantibodies target and attack healthy tissue. Quitting can reverse some of the damage.

Control high blood pressure. Work with your doctor to manage high blood pressure with changes in your eating habits, exercise, and medication.

Lose weight if you need to. Obesity raises blood pressure and ups your chance of diabetes, besides putting extra strain on your heart and joints.

Watch what you eat. Choose mostly fruits, veggies, and fatty fish. Add whole grains and healthy fats like olive oil. Things like caffeine, soda, and red meat aren’t heart-healthy and can worsen RA symptoms.

Stay active. There’s almost no problem exercise can’t solve or prevent. It lowers blood pressure and blood sugar, and helps with weight loss. It also eases joint pain and inflammation, and strengthens muscles so you’re less likely to fall. Studies show that older adults with RA can benefit from most types of exercise, especially a combination of strength training and cardio – the kind that gets your heart rate up. If you’re not active now, start slowly and work up to at least 30 minutes of exercise on most days.

Staying Socially Active and Engaged

Older adults can feel lonely and isolated for many reasons. They may lose friends and family, have trouble getting around, or have poor vision or hearing. Ongoing pain and fatigue from RA can make things worse. But you don’t have to stay stuck in that cycle. Even if you can’t be as socially active as you used to be, you can still maintain relationships. Here are a few tips:

Join an online or local support group for people with arthritis. You can find one through the Arthritis Foundation, CreakyJoints, and most hospital social workers.

Volunteer. You may find a renewed sense of meaning and purpose. As a bonus, you’ll meet lots of new people.

Move your body. Exercise is still one of the best all-round prescriptions for RA. No matter what your age or fitness level, there’s an exercise for you. If you don’t know where to start, ask your doctor for a referral for physical therapy. Also, check out Silver Sneakers, a nationwide fitness program specifically for older adults, many with chronic illnesses or disabilities. You can take classes for free at home or in many gyms and community centers.

Think about social media. It’s one way to connect with others when getting out of the house is hard.

Adopt an animal companion. If you’re able to afford and care for a dog or cat, consider adopting one. They can be a source of emotional support.

Show Sources

SOURCES:

Arthritis Care & Research: “Risk Factors for Falls in People with Rheumatoid Arthritis: A Prospective Study.”

BMC Musculoskeletal Disorders: “Association between sarcopenia, physical performance and falls in patients with rheumatoid arthritis: A 1-year prospective study.”

Immunity & Aging: “Accelerated immunosenescence in rheumatoid arthritis: Impact on clinical progression.”

CDC: “Facts about Falls,” “Loneliness and Isolation Linked to Serious Health Problems.”

Harvard Health Publishing: “Medications that increase your risk of falling.”

Calcified Tissue International: “Vitamin D, Autoimmune Disease, and Rheumatoid Arthritis.”

Arthritis Foundation: “Rheumatoid Arthritis and Heart Disease.”

Cardiovascular Endocrinology & Metabolism: “The relationship between rheumatoid arthritis and diabetes mellitus: A systematic review and meta-analysis.”

Clinical Therapeutics: “Potential of Lifestyle Changes for Reducing the Risk of Rheumatoid Arthritis: Is an Ounce of Prevention worth Pound of Cure?”

Arthritis Care & Research: “Effects of Aerobic and Resistance Exercise in Older Adults with Rheumatoid Arthritis: A Randomized Controlled Trial.”

Autoimmunity Reviews: “Rheumatoid arthritis: Extra-articular Manifestations and Comorbidities.”

Journal of Clinical Medicine: “Systemic Manifestations and Complications in Patients with Rheumatoid Arthritis.”

Clinics in Chest Medicine: “Thoracic Manifestations of Rheumatoid Arthritis.”

Arthritis & Rheumatology: “2017 American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis.”

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