Rheumatoid Arthritis Guide
|Who Is Likely To Develop Rheumatoid Arthritis?
The actual cause of rheumatoid arthritis (RA) is unknown. In most cases it is believed to be influenced by both genetic factors and environmental exposures.
Fixed Non-Modifiable Factors
A non-modifiable factor is a cause that you can nothing about - you can’t for example do anything about your gender, age or genes.
Women are 3 times more likely to develop RA than men.
Although RA can start at any age, it is most likely to start between the ages of 25 and 50. When symptoms develop after the age of 60, it is called elderly onset rheumatoid arthritis. Elderly RA tends to be less severe and has a better outcome than RA that starts in younger years.
Although scientists have not yet pinpointed a specific gene that causes RA, the strongest candidate is gene PTPN22. It has been linked to several other autoimmune conditions.
Modifiable factors are risk factors you can do something about, even if that means seeking treatment.
There is strong and consistent evidence linking the onset of RA to smoking. Women who smoke are 1.3 to 2.4 times more likely to develop RA than non smokers. Smokers who are ACPA-positive (anti-citrullinated protein/peptide antibodies), are the most likely to develop symptoms of rheumatoid arthritis. ACPA is a marker found in the blood that indicates autoimmune activity. Your doctor can perform a blood test to check the status of this marker in your blood.
Reproduction And Breastfeeding History
The link between reproductive hormones, fertility and RA has been investigated extensively. High estrogen levels seem to provide some sort of protection. Most women with RA find that their symptoms abate or even go into complete remission during pregnancy when estogen levels spike; although it usually flares up again within 6 to 9 months of delivery (when estrogen returns to normal). Read more about the effects of estrogen on the body.
Early studies in the 1960s found that oral contraceptive pills slightly decreased the risk of RA. However in more recent studies, this has not been found. The reason is probably because modern pills contain 80 to 90 percent less estrogen than earlier versions.
Estrogen Replacement Therapy
There has been mixed evidence about the association between estrogen replacement therapy (ERT) and RA.
There is a slight to moderate increased risk of developing RA if you have NOT given birth to a live baby.
Recent studies show that breastfeeding appears to lower the risk of RA.
At least 2 studies show that women with irregular periods or women who start menopause early are at increased risk of RA. Women with PCOS (a condition associated with irregular periods) have an increased risk of RA, probably for this reason.
Rheumatoid Arthritis Statistics
• RA affects 0.5 to 1.0 percent of the general population. In 2005, an estimated 1.5 million Americans adults had the disease.
• In 2009, 15,600 patients were hospitalized because of RA. The average hospital fee per patient was $35,000. Women and those aged over 45 accounted for the majority of these stays.
• In 2009 RA patients accounted for 2.9 million ambulatory care visits. Most of these were to a doctor’s office (2.6 million), with 1.9 million of those to a specialist such as a rheumatologist. This was a decrease from 4 million ambulatory visits in 1997.
• The Rochester Epidemiology Project found that people with RA were 3.3 percent more likely than those without the condition to change occupation. 12 percent sought reduced work hours (versus 1.7 percent without arthritis); 3.3 percent lost their job (vs. 0 percent); 26 percent retired early (versus 5 percent) and 15 percent were unable to find a job (versus 5 percent).
• It is estimated that 33 percent of those with RA will not be working 5 years after diagnosis and 50 percent after 10 years. Risk factors for early work disability include older age, physically demanding job, lower education and the inability to carry out daily tasks. Work disability is considered a longterm consequence of RA. When someone becomes work-disabled due to RA they rarely go back to work again. Reports indicate that early treatment with rheumatoid medications such as biologic drugs and non-biologic DMARDs may help delay the onset of work disability.
• Those with RA, it is estimated, will have a 5 to 10 year shorter life span than those without the disease.
• The average lifetime cost of RA (25 years following a diagnosis of rheumatoid arthritis) is between $61,000 and $122,000. Source, Gabriel et al, 1998.
• 40 percent of people with RA are likely to report poor health compared to those without arthritis. 30 percent are more likely to need help with personal care and they are twice as likely to report activity limitation due to their health.