What Is Late-Onset Lupus?

Although the age of onset of lupus is typically between 15 and 44 years old, up to 25% of people diagnosed with systemic lupus erythematosus (SLE) have late-onset lupus.

Lupus is most commonly diagnosed between the ages of 16 and 55, and is more common in women and in African-Americans, Hispanics, and Asians. However, lupus can strike women and men of all ages and races.

Even if you're older, you can still develop lupus.

A patient meets with a doctor
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Who Gets Late-Onset Lupus?

Although the cause of late-onset lupus is unknown, it's possible that changes to the immune system that occur with aging predispose some older people to this and other autoimmune disorders.

Most studies define late-onset lupus as beginning at age 50, but there is no consensus on this. Some doctors think the term should apply only when lupus develops in people over age 65 or even older.

Research shows that anywhere between 4% and 25% of lupus patients have late-onset lupus. Lack of agreement on the age cut-off could help to explain why this range is so large. The incidence of late-onset lupus may also be underestimated by some.

Both women and men can get late-onset lupus. If you are a woman, you may have four times greater chance of being diagnosed with lupus than a man of the same age. And, while men are less likely to get the disease, they're more likely to get it when they're older.

Caucasians may be more likely to have late-onset lupus than African Americans and Hispanics.

Diagnosing Late-Onset Lupus

Many otherwise healthy adults could mistake lupus for other conditions found in aging people, such as arthritis, pleurisy, pericarditis, muscle aches, dry eyes, and dry mouth.

This, and the fact that lupus in anyone is difficult to diagnose, can mean that late-onset lupus is not diagnosed right away. It is often misdiagnosed as drug-induced SLE or a different rheumatic disease.

There's an average delay of about two years between when the symptoms start and when a person is finally diagnosed with late-onset lupus. On average, lupus symptoms in older people begin at around age 59, but the diagnosis isn't usually made until age 62.

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The options for your lupus medications are the same regardless of your age of onset. However, if you have late-onset lupus, you may need different dosages than younger lupus patients. This will depend on your other medications and your health status, including other health conditions you may have.

Older adults with lupus may present with different symptoms. Studies have revealed conflicting findings as to whether late-onset lupus is a more benign disease. A study published in a 2014 issue of the journal Lupus found that the later age at diagnosis group had a decreased 10-year survival rate.

Because older adults often have other diseases and health problems, the outcomes for late-onset lupus are not generally better than those of people diagnosed with lupus at a younger age.

As more patients, doctors, and researchers understand that lupus can strike at an older age, earlier diagnoses and even more effective treatments may become possible.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Lupus Foundation of America. Risk factors for developing lupus

  2. Lupus Fioundation of America. Lupus facts and statistics

  3. Stefanidou S, Gerodimos C, Benos A, et al. Clinical expression and course in patients with late onset systemic lupus erythematosus. Hippokratia. 17(2):153-6

  4. Weckerle CE, Niewold TB. The unexplained female predominance of systemic lupus erythematosus: clues from genetic and cytokine studies. Clin Rev Allergy Immunol. 2011;40(1):42-9. doi:10.1007/s12016-009-8192-4

  5. Gergianaki I, Bertsias G. Systemic lupus erythematosus in primary care: an update and practical messages for the general practitioner. Front Med (Lausanne). 2018;5:161. doi:10.3389/fmed.2018.00161

Additional Reading
  • Late-onset Lupus: Facts and Fiction. Future Rheumatology.

  • Late Onset Lupus Fact Sheet. Lupus Foundation of America.

By Jeri Jewett-Tennant, MPH
Jeri Jewett-Tennant, MPH, is a medical writer and program development manager at the Center for Reducing Health Disparities.