Rheumatoid arthritis risk factors: who is more likely to get RA

What rheumatoid arthritis is

RA is a long-lasting autoimmune disease: the immune system, which normally protects the body, attacks its own tissues. It mostly affects the joints, causing pain, swelling, stiffness and loss of function. It often occurs in a symmetrical pattern, so if one hand or knee is affected, the other often is too. RA can also cause problems outside the joints, in the heart, lungs, blood, nerves, eyes and skin (NIAMS).

RA is different from osteoarthritis, the common arthritis that often comes with age (MedlinePlus). There is no cure, but early treatment can help manage symptoms and reduce joint damage (MedlinePlus).

Risk factors

NIAMS lists these risk factors for RA (NIAMS):

• Age. RA can happen at any age, but the risk goes up with older age. Children and younger teens may be diagnosed with juvenile idiopathic arthritis, a related condition.
• Sex. RA is more common in women: about two to three times as many women as men have it. Researchers think reproductive and hormonal factors may play a role for some women.
• Family history and genetics. If a family member has RA, you may be more likely to get it. Several genetic factors slightly increase the risk.
• Smoking. People who smoke over a long period of time are at higher risk, and in people who keep smoking, the disease may be more severe.
• Obesity. Some research shows obesity may raise the risk and limit how much the disease can improve.
• Periodontitis. Gum disease may be linked to developing RA.
• Lung diseases. Diseases of the lungs and airways may also be linked to developing RA.

MedlinePlus gives the same list: older age, being a woman, family history, long-term smoking, and obesity, gum disease or lung disease (MedlinePlus).

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What may cause RA

Doctors do not know why the immune system turns against the joints. NIAMS says a combination of factors may lead to RA (NIAMS):

• Genes that affect how the immune system works. Some people with these genes never get RA, so genes are not the only factor.
• Environment. Researchers are studying how cigarette smoke may trigger RA in people with genes that raise their risk. Inhalants, bacteria, viruses, gum disease and lung disease may also play a role.
• Sex hormones, together with genes and environment. Women are more likely to get RA, and the disease may improve during pregnancy and flare after it.

The immune system may be active years before symptoms appear (NIAMS).

Early signs to bring to a doctor

Common symptoms include (NIAMS):

• joint pain at rest and when moving, with tenderness, swelling and warmth
• joint stiffness that lasts longer than 30 minutes, often after waking or after resting a long time
• joint swelling that makes daily tasks hard, such as making a fist, combing hair, buttoning clothes or bending knees
• fatigue, an occasional low-grade fever and loss of appetite

RA is more common in the wrists, hands and feet, and symptoms often appear on both sides of the body (NIAMS). There is no single test for RA. A provider may ask about your symptoms and family history, examine your joints, and order blood tests or imaging, and may refer you to a rheumatologist (MedlinePlus).

Common questions

At what age does rheumatoid arthritis usually start?

RA can start at any age, and the risk rises as you get older (NIAMS) (MedlinePlus). Neither source gives a single typical starting age.

Is rheumatoid arthritis genetic?

Partly. A family member with RA makes you more likely to get it, and several genetic factors slightly raise the risk, but some people with these genes never get RA (NIAMS).

Which risk factors can I change?

Smoking can be changed, and obesity and gum disease can be worked on with your care team. Age, sex and genes cannot be changed (NIAMS).

Does RA affect other health risks?

RA can cause problems outside the joints, including anemia and inflammation and scarring in the lungs (NIAMS). Our guides on osteoporosis risk factors and heart disease risk factors list rheumatoid arthritis among the conditions that raise those risks, with their own sources. See also anemia risk factors.

Also see asthma risk factors and screening tests by age.

Also see hypothyroidism risk factors.