Multiple Co-Morbidities Connected to Worse Rheumatoid Arthritis Health Outcomes

A systematic review of 19 rheumatoid arthritis (RA) studies found RA patients with multiple co-morbidities (or two or more long-term conditions) experienced impacts to their health and quality of life according to a new study published in Arthritis Care & Research titled, "Examining the Relationship between Rheumatoid Arthritis, Multimorbidity and Adverse Health‐related Outcomes: a Systematic Review."¹

Managing several chronic conditions

The studies they reviewed were conducted between 1985 and 2019 with a variety of participant numbers (ranging from 183 to 18,485). The mean ages of participants ranging from nearly 54 to nearly 67 years old.

What were the results of the study?

They found that multimorbidity (several accompanying chronic conditions) increased all causes of death in patients (in 9 of 10 studies reporting deaths).

Additionally, all of the 10 studies exploring the connection between multimorbidity and functional status and quality of life found that multimorbidity predicted reduced function and impaired quality of life.¹

Multimorbidity was found to contribute to functional decline over time. And, psychologic comorbidities were found to be risk factors for increased disability. “Our review findings indicate that multimorbidity is a significant predictor for higher mortality and poorer functional status/quality of life in people with RA and should be considered in clinical management plans.”¹

Addressing RA symptoms to reduce further harm

While it is unsurprising that an increased number of co-occurring health conditions worsens health outcomes and quality of life, it is helpful to have this data to better understand the impacts on people living with RA.

In many ways, the RA battle may start in the joints and continue to expand to other territories that must be identified and addressed promptly to reduce further harm.

For example, if we have joint pain and, therefore, difficulty exercising, RA patients can quickly gain too much weight and then have additional conditions to combat (such as diabetes and heart disease). Managing the RA must include understanding these impacts and risks of additional illness.

Attention to other conditions helps with overall health

Some people may argue that the age range of people in the studies lends itself to more chronic conditions, but I would argue that is not necessarily the case or doesn’t have to be what happened.

Diligent treatment and attention from the health care team can result in preventing acquiring chronic conditions and also successful management of them. For example, diabetes doesn’t have to be life-threatening if it is diagnosed and well-managed.

Why I work on my overall health

As someone who is middle-aged and has lived with juvenile idiopathic arthritis (JIA) for more than 40 years, I view my health mission as not just to manage my JIA as much as possible, but to work on my overall health.

Keeping track of and managing my health conditions

I want to prevent acquiring other chronic conditions and also keep track of the ones I have. For example, two years ago I was surprised to be diagnosed with a rare form of psoriasis (another autoimmune disease that affects the skin).

At the time, I didn’t know I had it and developed a serious infection because it was untreated. Now that I have been diagnosed, I manage it daily and have prevented further serious illness.

Additionally, I manage my diet and exercise regularly to prevent heart disease and diabetes. I may continue to acquire chronic conditions, but I want to do everything that I can to minimize the possibility and control (as much as possible) the conditions I do have.

An attentive health care team

Thankfully, I have a good health care team that is focused on attending to my multiple conditions. It’s been really important to have multiple specialists, in addition to my general practitioner, that keeping an eye out for issues and helping me to manage my health complexities.

While patients need to be vigilant and aware of possible complicating conditions, they also need doctors aware of these potential problems and alert to treating them as soon as possible should they appear.