How Does Rheumatoid Arthritis Affect Life Expectancy?

Does Rheumatoid Arthritis Shorten Your Life?

Rheumatoid arthritis (RA) usually is not fatal, but complications of the disease can shorten a person’s lifespan. No one knows for sure how their lifespan with RA will be affected, so it is important to be aware of what affects life expectancy, including disease progression, lifestyle, and treatment failure or success.

Outlook for People With RA

In 1981, researchers from the Royal National Hospital for Rheumatic Diseases in the United Kingdom reported on a study of 100 RA patients who were followed from the early months of their disease for up to 18 years. Of the 100 study subjects, 43 had since passed away. Of those 43, RA contributed to nine of those deaths, while disease complications and its treatments contributed to seven deaths. The remaining 27 died of causes unrelated to RA and were much older than those who died due to RA. The survivors were experiencing fewer symptoms and better function after one year compared to those who had died. The survivors were also younger than the others at the onset of their disease.

A 2014 study out of the United Kingdom found major improvements in life expectancy among people with RA, this compared to studies from 25 years ago. The researchers collected information from 1986 to 1998 and then did the same for the years 2002 to 2012. The average age of death increased from 76.7 to 86.7 for a 27 percent decrease in mortality. There are some conflicting factors related to both studies, but the researchers do believe that the decreased mortality is related to RA research and treatment advances.

RA research and treatment has come a long way over the past few decades and the outlook for RA patients continues to improve. Today, doctors understand how to diagnosis RA quickly and early, how to best manage symptoms, and how to pursue treatments to keep the disease from progressing.

Of course, there are cases of RA where people suffer from severe symptoms and don’t respond to treatment. Unfortunately, those are the cases that can lead to a shortened lifespan.

How Does RA Affect Lifespan?

Laura Porter / Verywell

What Affects Life Expectancy?

Researchers have not been able to pinpoint an exact life expectancy for people with RA. But in general, people with RA can expect a shortened lifespan of an average of 10 years. That being said, research like the 2014 study above suggests the gap in lifespan is getting smaller for people with RA, perhaps due to improved treatments and awareness of RA complications.

RA lifespan is determined by a number of factors, including: 

  • Lung complications: People with RA are at greater risk for health complications because they have weakened immune systems. The lungs are particularly vulnerable and 30-40% of RA patients' lungs are affected, with lung conditions involved in 10% of RA patient's deaths. Inflammation and lung scarring can lead to breathlessness, so patients should pay attention to their lung function.
  • Cancer risk: The risk for certain cancers is higher in people with RA, particularly lung cancer and lymphoma. The incidence of lymphoma in RA patients is twice that of the general population.
  • Heart disease. Roughly one third of RA-related deaths involve heart disease. Some of this may be due to chronic inflammation from the disease, as well as compromised blood flow in affected vessels.
  • Drug complications: Some RA drugs (azathioprine, cyclophosphamide, corticosteroids, and certain biologics) may increase your chances of infection.
  • Gender: Women are two to three times more likely to have RA than men are, and women’s symptoms are worse than men’s. RA in women tends to be more progressive, which can lead to complications. While RA in men tends to be less severe, men with RA have a higher risk of developing heart disease related to RA inflammation.
  • Diet. A diet high in sugar and unhealthy fats may increase the inflammatory response in the body. Conversely, a diet high in antioxidants, fiber, and healthy fats may have an anti-inflammatory affect and promote healthier intestinal flora, which also can help lower chronic inflammation.
  • Smoking: People with RA are advised not to smoke. Research shows a strong connection between smoking and the severity of RA. Smoking causes lungs to be inflamed and may even activate antibodies that cause RA to progress. Further, having a weakened immune system can lead to respiratory disorders.
  • Seropositive RA: People with seropositive RA tend to have a more severe form of RA, which could mean more joint deformity, inflammation outside joints (i.e. organs) and an increased risk for disability.

Age and Life Expectancy

Age can be a major factor in RA life expectancy. The younger a person is at the onset of RA, the more likely they are to have more severe symptoms and complications. This is because the duration of the disease is longer.

Children developing the juvenile form of the disease are particularly vulnerable. Juvenile rheumatoid arthritis (also called juvenile idiopathic arthritis, JIA) occurs in children age 16 or younger.

Juvenile RA patients do have a higher mortality rate than the general population, but outcomes will be individualized based on the severity of the disease. For example, one study of children with systemic juvenile RA, a more severe form of the disease, had a much higher mortality rate than non-systemic cases.

Improving Life Expectancy

Early and aggressive treatments with disease-modifying anti-rheumatic drugs and biologics can improve quality of life and life expectancy. The goal of RA treatment is to reduce pain and improve symptoms and quality of life. An effective treatment plan with the assistance and monitoring of a rheumatologist can prevent or treat complications as they develop.   

There is no cure for RA, but treatments may help people achieve remission. Remission means RA symptoms quiet down and a person starts to feel better. 

A Word From Verywell

The rate of premature death is higher for people with RA than it is in the general population. And while RA usually is not fatal, the disease’s complications have been known to shorten lifespan for some people. But newer, more aggressive, treatments have reduced the potential for complications, joint damage, and disability and increased the potential for remission, which means people with RA are living longer.

There are many people with RA managing their diseases successfully, enjoying good quality lives, and even living well into their 80s and 90s and even beyond. Make sure you are consulting regularly with a rheumatologist, making healthy choices, and following the treatment plan recommended by your doctor to improve your own health outcomes, life quality, and longevity.

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