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With the advent of a super\u2010aging society and extended life expectancies, a significant increase in the incidence of LORA is anticipated. In comparison to young\u2010onset RA (YORA), LORA is predominantly characterized by a higher incidence of acute onset, augmented disease activity and constitutional symptoms, a propensity for systemic manifestations, increased erythrocyte sedimentation rate at disease onset, reduced seropositivity, a predilection for involvement of large and proximal joints with symptoms resembling polymyalgia rheumatica, a higher frequency of erosive disease, and a more evenly distributed gender ratio. Elderly individuals, particularly those with multimorbidity and on multiple medications (polypharmacy), are at an elevated risk of developing geriatric syndromes, including sarcopenia and frailty. The response to TNF inhibitors in elderly individuals with RA is generally comparable to that in younger patients, though it may be slightly diminished. The duration of the disease appears to have a more pronounced impact on outcomes than the patient's age. For the management of LORA, it is critical to adopt a patient\u2010specific approach. Non\u2010frail LORA patients who are otherwise aging healthily should receive aggressive treat\u2010to\u2010target management. Conversely, in pre\u2010frail and frail patients, the therapeutic focus should be on averting the progression of irreversible geriatric conditions. The confluence of multimorbidity, polypharmacy, and geriatric syndromes in this patient population necessitates a tailored therapeutic approach to maintain patient autonomy and functional status.<\/jats:p>","DOI":"10.1111\/ggi.70399","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T08:56:01Z","timestamp":1771577761000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Insights Into Late\u2010Onset Rheumatoid Arthritis (\n                    <scp>LORA<\/scp>\n                    ): Characteristics (Clinical and Imaging), Comorbidities, and Therapeutic Targets"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3794-6831","authenticated-orcid":false,"given":"Fausto","family":"Salaffi","sequence":"first","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Dipartimento di Scienze Cliniche e Molecolari, Universit\u00e0 Politecnica Delle Marche  Jesi, Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6562-180X","authenticated-orcid":false,"given":"Marina","family":"Carotti","sequence":"additional","affiliation":[{"name":"Clinica di Radiologia, Ospedali Riuniti di Ancona, Universit\u00e0 Politecnica Delle Marche  Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9815-2621","authenticated-orcid":false,"given":"Sonia","family":"Farah","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Dipartimento di Scienze Cliniche e Molecolari, Universit\u00e0 Politecnica Delle Marche  Jesi, Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6874-4941","authenticated-orcid":false,"given":"Francesca","family":"Bandinelli","sequence":"additional","affiliation":[{"name":"Rheumatology Department San Giovanni di Dio Hospital, USL Tuscany Center  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0510-0970","authenticated-orcid":false,"given":"Luca","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit, IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-7051","authenticated-orcid":false,"given":"Andrea","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0906-4647","authenticated-orcid":false,"given":"Marco","family":"Di Carlo","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, \u201cCarlo Urbani\u201d Hospital, Dipartimento di Scienze Cliniche e Molecolari, Universit\u00e0 Politecnica Delle Marche  Jesi, Ancona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"issue":"6","key":"e_1_2_13_2_1","first-page":"829","article-title":"Health\u2010Related Quality of Life in Multiple Musculoskeletal Conditions: A Cross\u2010Sectional Population Based Epidemiological Study. 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