Ankylosing Spondylitis Life Expectancy: What You Need to Know

Introduction

Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the spine and sacroiliac joints. As with any chronic illness, patients and their loved ones often wonder about its impact on life expectancy. In this article, we'll explore the latest research on AS and longevity, discuss potential complications, and provide strategies for optimizing health outcomes.

Does Ankylosing Spondylitis Affect Life Expectancy?

Recent studies have shown mixed results regarding the impact of AS on life expectancy. A large population-based study found that AS patients have an increased standardized mortality rate (SMR) of 1.37 compared to the general population. This increase was particularly significant for HLA-B27-positive AS patients, with an SMR of 1.38.

However, it's important to note that many patients with AS can lead long, productive lives with proper management. Some recent studies of patients treated and monitored according to improved methods developed in recent years do not support excess mortality in these patients.

Factors Influencing Life Expectancy in AS

Several factors can influence the long-term prognosis for individuals with AS:

• Age of onset: Most people with AS are diagnosed before age 45, with onset typically occurring between ages 20 and 40.
• Gender: AS is diagnosed three times more often in men than in women, and some studies suggest that men may have a slightly higher mortality risk.
• Disease severity and progression: More severe disease and rapid progression can lead to greater complications.
• Presence of comorbidities: Conditions like cardiovascular disease can impact overall health outcomes.
• Treatment adherence and response: Proper management of AS can significantly improve long-term outcomes.

Potential Complications Affecting Longevity

While AS primarily affects the spine, it can lead to complications that may impact life expectancy:

1. Cardiovascular Disease

Research has shown that AS patients have an increased risk of cardiovascular mortality. The adjusted hazard ratio for vascular death in AS was 1.36 overall, with a slightly higher risk for men (1.46) compared to women (1.24).

2. Respiratory Issues

AS can affect the chest wall and lungs, potentially leading to reduced lung capacity and increased susceptibility to respiratory infections.

3. Spinal Fractures

The fusion of the spine in advanced AS can make it more brittle and susceptible to fractures, which can have serious consequences.

Strategies for Improving Long-Term Health Outcomes

While AS can present challenges, there are several strategies patients can employ to improve their long-term health outcomes:

1. Early Diagnosis and Treatment: Research indicates that spinal structural damage in AS progresses most rapidly when patients are 30-39 years old. Early intervention can help slow disease progression.
2. Medication Adherence: Consistently taking prescribed medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and biologics, can help manage inflammation and slow disease progression.
3. Regular Exercise: Maintaining flexibility and strength through appropriate exercises is crucial for managing AS symptoms and preserving function.
4. Cardiovascular Health: Given the increased risk of cardiovascular complications, it's essential to manage risk factors such as high blood pressure, cholesterol, and maintain a healthy weight.
5. Smoking Cessation: Smoking can exacerbate AS symptoms and increase cardiovascular risk. Studies have shown a decrease in current smoking among AS patients between 2002 and 2019.
6. Regular Monitoring: Consistent check-ups with a rheumatologist can help catch and address any complications early.

Conclusion

While ankylosing spondylitis can impact life expectancy, particularly for those with more severe disease or complications, many patients can lead long, fulfilling lives with proper management. Early diagnosis, adherence to treatment plans, and adopting a healthy lifestyle are key factors in improving long-term outcomes. As research continues to advance our understanding of AS and new treatments become available, the outlook for patients continues to improve. If you have AS, work closely with your healthcare team to develop a comprehensive management plan tailored to your individual needs.