January 27, 2013
Rheumatoid Arthritis (RA) is an autoimmune disease- meaning the body’s immune system mistakenly attacks healthy tissues including the joints in the wrists, fingers, knees, ankles, and feet as well as causing damage to the lungs, arteries, blood vessels, spinal cord and heart (Falvo, 2009). Rheumatoid arthritis is a chronic disease characterized by periods of flares and remissions (NIAMS, 2009). Rheumatoid Arthritis (RA) can cause negative effects on an individual’s ability to participate in work, family life, leisure, and social relationships, but with early diagnosis, disease education, and effective treatment patients can lead normal functional lives. In 2005, an estimated 1.5 million or about 0.6 percent of the U.S. adult population had RA (NIAMS, 2009) and (CDC, 2012). Based on data from 1965-1990, it was found that people with RA are more than twice as likely to die than people of the same age in the general population (CDC, 2012). Rheumatoid arthritis is thought to be caused by a combination of genetic and environmental factors but at the present time there is no known cause of RA. Although, a definite cause is unknown, there are several known risk factors some which are considered modifiable (CDC, 2012). These include: family history, age, gender, reproductive/breastfeeding history and smoking. Doctors and specialist believe that a family history of the disease makes an individual much more likely to develop the disease. However, the majority of physicians and scientists do not believe that rheumatoid arthritis is directly inherited (CDC, 2012). Instead, a predisposition for the development of the disease is inherited which makes that individual more likely to develop the disease (CDC, 2012). The development of the condition rheumatoid arthritis most commonly occurs between the ages of 40-60, or middle age (CDC, 2012). However, it can be diagnosed at any age, as seen in patients with juvenile rheumatoid arthritis (CDC, 2012). RA can affect any gender but is more commonly seen in women. Approximately two to three times as many women as men are affected by the disease (NIAMS.2009). It is not understood why women are more likely to develop rheumatoid arthritis than men but research continues in this area and several theories are being examined and tested. The most prominent theory about the development of RA being more common in women is associated with changes in the levels of sex hormones, including estrogen and progesterone. These hormones have critical roles in the inflammatory response, and in the overall regulation of the immune system. This is in correlation with the risk factors associated with reproductive health (Oliver & Silman, 2006). More research and testing are still needed to assess the accuracy of this theory. Research is also being done to determine whether a history of irregular menstrual cycles, earlier age at menarche, use of oral contraceptives for birth control, pregnancy complications increase the risk of RA and if breastfeeding trends toward a lower risk of developing RA (CDC, 2012) & (Oliver & Silman, 2006) . The development of rheumatoid arthritis is more likely in smokers than in non-smokers (CDC, 2012). Individuals diagnosed with rheumatoid arthritis who smoke also report having a faster developing, more severe form of the disease. Not only is smoking correlated with an increased risk for the development of rheumatoid arthritis, but is also associated with the development of many other life threatening conditions. However, studies have shown that quitting smoking can decrease the overall risk of developing RA as well as other health conditions. Studies have shown progressive and fairly rapid loss of function among people with rheumatoid arthritis and the greatest decline in function generally occurring within the first two years of disease...