NUTRITIONAL STATUS IN PATIENTS WITH LATE-ONSET RHEUMATOID ARTHRITIS: A CROSS-SECTIONAL STUDY

Introduction. This study aimed to investigate the nutritional status of older patients with rheumatoid arthritis (RA) classified as earlier-onset (EORA) and late-onset (LORA). Methods. The cross-sectional study included 145 older patients with RA (72 patients with LORA, 73 patients with EORA). Clinical and demographic data, and the nutritional status of the patients were recorded. The nutritional status was determined using the Mini-Nutritional Assessment (MNA), Prognostic Nutritional Index (PNI), the Controlling Nutritional Status (CONUT), and Geriatric Nutritional Risk Index (GNRI) indices. The rheumatologic and nutritional data of the EORA and LORA patients were compared. Patients in both groups were divided into two groups according to the DAS28-CRP index (cut off= 3.2), and cross comparisons were made in nutritional indices. Also, the prediction of disease activity by malnutrition according to the GNRI scale was evaluated by ROC analysis. Results. The highest prevalence of malnutrition in older patients with RA was 20.5%, as measured by the CONUT score. The mean GNRI score was statistically higher in the EORA group than in the LORA group (128.38±15.36 vs. 121.96±21; p=0.040), and a significant difference was observed between CONUT categories, indicating more malnutrition in LORA patients (p=0.009). In the cross-comparisons, the GNRI malnutrition score showed lower values in patients with a high disease activity compared to those without, a difference observed in both patient groups (p = 0.023 for EORA; p = 0.011 for LORA). However, on ROC analysis, the GNRI score was able to predict high disease activity only in the EORA group [AUC (CI):0.594 (0.451-0.737); p=0.041]. Conclusion. The present study demonstrated that malnutrition was more prevalent in LORA patients according to GNRI and CONUT indices. Furthermore, it was revealed that the time of disease onset and disease activity should be evaluated in conjunction during the nutritional assessment of older RA patients.