Can Arthritis Shorten Your Lifespan?

There are more than 100 types of arthritis. Some are progressive and may shorten lifespan, especially rheumatoid arthritis (RA), which is an autoimmune disease (the immune system attacks healthy cells), and gout, which can lead to serious complications if left untreated.

Arthritis by itself is not fatal, but research has shown that the complications that may arise in more severe cases can shorten lifespan by six to seven years. There are many ways to reduce your risk of complications from arthritis.

Types of Arthritis That Can Affect Lifespan

Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory and autoimmune disease that occurs when the immune system doesn’t work properly and attacks the lining of the joints (called the synovium). The inflamed synovium becomes thicker and makes the joint area feel painful and tender, look red and swollen, and moving the joint may be difficult. RA commonly affects the hands, knees, or ankles, and usually the same joint on both sides of the body. However, RA can also cause problems in other parts of the body, including the eyes, heart and circulatory system, and lungs. For this reason, people with RA are more prone to have comorbidities, which raise the mortality rate even when the disease goes into remission.

Gout

Gout is the result of too much uric acid in the body (hyperuricemia) and forming crystals around the joints, leading to intense pain and swelling. The body makes uric acid when it breaks down purines, which are found in your body and some foods, such as red meat and certain types of seafood. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Gout is also associated with a number of comorbidities, including metabolic syndrome, cardiovascular disease, and chronic kidney disease, which contribute to higher mortality rates among people with gout.

Psoriatic Arthritis

Psoriatic arthritis (PsA) is an inflammatory form of arthritis that affects about 30% of people with the skin disorder psoriasis. Like psoriasis, PsA is an autoimmune disease. Psoriasis causes patches of red, irritated skin that are often covered by flaky white scales. In 85% of people with psoriatic arthritis, psoriasis appears before joint problems develop. Those with PsA have stiff, painful joints with redness, heat, and swelling in the surrounding tissues. Research has found that mortality may be increased in more severe cases of PsA due to a higher cardiovascular risk.

Arthritis and Life Expectancy

Five primary risk factors can help determine life expectancy with arthritis.

Chronic Inflammation

Chronic inflammation can potentially shorten the life expectancy of someone with arthritis. For example, chronic inflammation caused by RA that is not adequately treated at an early stage or does not respond to treatment can induce joint fusion, generalized bone loss, osteoporosis, and fractures. The prevalence of osteoporosis was 1.5- to twofold higher in RA patients than the general population. The development of osteoporosis increases the incidence of femoral neck and vertebral compression fractures, leading to a further decrease in quality of life and increased mortality. 

Autoimmune Disease

Autoimmune diseases are treated with immunosuppressive drugs, which can lower the body’s defenses against infections and make someone vulnerable to illness. RA patients, who are often treated with disease-modifying anti-rheumatic drugs (DMARDs), are widely known to have a higher risk of infection than the general population, and serious infection is one of the main causes of death in RA. The lower respiratory system is the most commonly involved site, and the other frequently involved sites are the skin, soft tissues, bloodstream, bones, joints, and urinary tract.

Disease Duration

As new and better medications for progressive forms of arthritis like RA become available, people with these conditions are living longer lives, but that also means they have a longer disease duration. The risk of comorbidities therefore becomes a central issue in those living with RA, particularly because comorbidity can be a threat to the improvement in the long-term prognosis in patients with RA. 

Untreated Disease

If left untreated, inflammatory forms of arthritis can be seriously damaging to a person’s health. Treatment with DMARDs and other biologics can significantly reduce mortality rate among people with RA. For example, a small study found that the mortality rate for people treated with biologic agents was 12.6%, DMARDs was 22.3%, and no treatment was 89.1%. Treatment is therefore essential for prolonging the life expectancy of people with RA.

Seropositive RA

Seropositive RA means that tests for anti-cyclic citrullinated peptide (anti-CCP) and/or rheumatoid factor (RF) found detectable levels of these antibodies in the blood. Seropositivity is associated with increased mortality among patients with RA compared with seronegativity. Mortality rates were greatest in patients with higher versus lower autoantibody titers in one study.

Other Risk Factors

Other risk factors that affect the longevity of people with arthritis include:

• Age: The age of symptom onset can be a predictive factor for age severity. A prospective cohort study of 950 RA patients found that those who started developing symptoms at a later age experienced greater radiological damage both at disease onset and over time. Patients who developed symptoms later in life were defined as those older than the cohort’s median age of 58 years. Other factors may have influenced the older participants’ prognosis, such as later disease management, with a greater portion of young patients (who experienced comparatively better outcomes over time) being treated earlier with DMARDs than older patients. Gout prevalence also increases with age.
• Biological sex: There is conflicting evidence on whether females are more likely to develop RA than males. However, autoimmune diseases are generally more common in females. One study reported that females tend to be diagnosed more often with gout than males as they age.
• Genetics: One study demonstrated that between 40% and 60% of the risk for the development of RA is determined by genetics. Research has also found that genetic polymorphisms related to renal urate excretion, which changes the levels of serum uric acid and the risk of gout.
• Obesity: Obesity has been associated with increased gout incidence. It has also been linked to increased arthritis activity in RA and PsA and a reduced probability of response to anti-tumor necrosis factor (TNF) agents, a type of biologic drug, while weight loss raises the chances of treatment success. Additionally, obesity increases the risk of psoriatic arthritis, possibly related to a higher level of pro-inflammatory mediators.
• Diet: Alcohol and sugary beverages are two examples of foods associated with increased gout incidence. A healthy diet can help you manage your overall well-being, including your weight. Meat and seafood have been associated with increased risk for gout, while dairy may help protect against gout.
• Smoking: Smoking is associated with increased risk of RA and RA symptom severity, even after smoking is stopped. Exposure to secondhand smoke in childhood may also increase a person’s susceptibility to RA. Smoking is a risk factor for psoriasis, and it is positively associated with PsA at the population level but negatively associated in patients with psoriasis. However, smoking may cause poor response and reduced adherence to treatment of both psoriasis and PsA.

Arthritis Complications

Heart Disease

Rheumatoid arthritis and gout are both associated with about a 50% to 70% increased risk of cardiovascular disease compared with the general population, even though they have different underlying causes. The chronic inflammatory process in RA and accumulation of uric acid crystals in the heart are said to be responsible for this increased risk. Both conditions are considered independent cardiovascular risk factors. Early treatment in RA has shown favorable effects on cardiovascular disease risk. However, evidence that urate-lowering therapy has consistent beneficial effects on cardiovascular outcomes is still scarce.

People with PsA also have been found to have an increased risk of cardiovascular diseases, mostly due to accelerating atherosclerosis (buildup of plaques in the walls of the arteries), which is caused by chronic inflammation.

Cancer

A number of studies show that people with RA have roughly double the average risk for developing lymphoma. This is likely caused by chronic inflammatory stimulation of the immune system. Two key producers of inflammation, lymphocytes called B cells and T cells, are the same cells that become cancerous in lymphomas. The increased activity of these lymphocytes in RA makes them more likely to turn malignant. 

Medications that affect the immune system have the potential to increase cancer risk as well. This appears to be the case with a few drugs that are infrequently used to treat RA, such as cyclophosphamide and azathioprine. However, one of the most widely used RA medications, methotrexate, has been linked to lymphoma. RA patients who take methotrexate are more likely to develop lymphoma if they also have the Epstein-Barr virus.

People with gout are at an increased risk of urological cancers, digestive system cancers, and lung cancer.

Organ Damage

RA, gout, and PsA can all affect multiple organs and cause systemic effects. Besides heart damage, RA also has the potential to cause liver damage. The presence of asymptomatic cardiovascular organ damage in RA patients is closely associated with hypertension independent of inflammatory activity.

Anemia

Many people with RA have a type of anemia called anemia of chronic disease (ACD). Mild cases of anemia can also be seen in people with PsA. With ACD, a person may have normal or sometimes increased amounts of iron stores in their body tissue, but a low level of iron in their blood. Chronic inflammation may prevent the body from using the stored iron to create new red blood cells, which leads to anemia. Inflammation can also affect the way the body produces a specific hormone called erythropoietin, which controls the production of red blood cells. 

Other Infections

The risk for infection is increased in people who take immunosuppressive medications. For example, corticosteroids suppress the immune infection by design, and while this assists with arthritic symptoms, it can also leave someone’s body more vulnerable to infections because their immune system is being suppressed and cannot fight back against the infections.

How to Reduce Your Risk of Complications

There are many ways you can reduce the risk of complications from arthritis:

• Stress reduction: Stress can result in flares in inflammatory arthritis, where existing symptoms spike in intensity. When you notice a potential worsening of symptoms, it is time to alert your support system and get help with labor-intensive tasks, such as grocery shopping or cleaning. Reducing stress can also help you minimize cravings for sugary foods, which can increase your risk of gout and gout attacks.
• Weight loss: Obesity has been associated with worsening RA and gout symptoms. Weight loss can therefore potentially help with your symptoms. Clinically relevant weight loss (more than 5 kg) was associated with improved RA disease activity in the routine clinical setting in one study. More research is needed to support the benefit of weight loss for gout.
• Quit smoking: Smoking is linked to both RA development and increased and more severe symptoms in RA. Smoking cessation can not only delay but also prevent seropositive RA.
• Seek treatment: Working with a trusted healthcare professional can ensure that you get a tailored treatment plan that provides you with the best possible outcomes.
• Vaccination: Living with an autoimmune disease and being on immunosuppressive drugs mean it is important to take steps to protect yourself from infections. This includes getting a flu or pneumonia shot per your healthcare provider recommendations.

When to See a Healthcare Provider

If you experience new symptoms or worsening of existing symptoms, contact your healthcare provider immediately.

A Word From Verywell

Arthritis alone does not cause death, but some of the complications that result from it are linked to early mortality. If you have symptoms of arthritis or feel that your symptoms are out of control, do not worry. You are not alone, and there are many resources to help you cope with your condition. The best thing you can do is ask for help. Ask your loved ones for support or consider joining a support group. Additionally, maintain close communication with your healthcare provider and ensure that you follow a recommended treatment plan to manage your arthritic symptoms so that you can live a long, healthy, and enjoyable life.