RT Journal Article SR Electronic T1 Mortality risk associated with rheumatoid arthritis in a prospective cohort of older women: results from the Iowa Women’s Health Study JF Annals of the Rheumatic Diseases JO Ann Rheum Dis FD BMJ Publishing Group Ltd and European League Against Rheumatism SP 994 OP 999 DO 10.1136/ard.61.11.994 VO 61 IS 11 A1 Mikuls, T R A1 Saag, K G A1 Criswell, L A A1 Merlino, L A A1 Kaslow, R A A1 Shelton, B J A1 Cerhan, J R YR 2002 UL http://ard.bmj.com/content/61/11/994.abstract AB Objective: To determine whether rheumatoid arthritis (RA) is associated with excess mortality among older women. Methods: RA associated mortality was examined in a prospective cohort study that was started in 1986, and included 31 336 women aged 55–69 years without a history of RA at baseline. Up to 1997, 158 cases of RA were identified and validated against medical records. The relative risk (RR) and 95% confidence interval (CI) were calculated as measures of association between RA onset and subsequent mortality (overall and cause-specific) using Cox proportional hazards regression. Results: Compared with non-cases, women developing RA during follow up had a significantly increased mortality risk (RR=1.52; 95% CI 1.05 to 2.20). Mortality was higher among rheumatoid factor (RF) positive cases (RR=1.90; 95% CI 1.24 to 2.92) than among RF negative cases (RR=1.00; 95% CI 0.45 to 1.99). There were trends towards increased proportions of RA related deaths from infection (RR=3.61; 95% CI 0.89–14.69) and circulatory disease (RR=1.46; 95% CI 0.76 to 2.81) but not malignancy (RR=0.97; 95% CI 0.46 to 2.04). Conclusions: RA was associated with significantly increased mortality in a cohort of older women, and the association appeared to be restricted to those with RF positive disease.