It was in October 2015 when actor-singer-entrepreneur Selena Gomez opened up about her diagnosis with lupus publicly. Since then, the 33-year-old has been vocal about her experiences and uses her platform to educate the public about the autoimmune condition.
Lupus is a chronic autoimmune disease where the immune system mistakenly attacks healthy tissues and organs, causing inflammation. One of the most concerning aspects of the condition is that it can affect various parts of the body, including the skin, joints, kidneys, brain, heart, and lungs. And with no cure, it can cause a lot of distress if not managed properly.
However, a recent study brought good news when it suggested that lupus symptoms improve as people age. While more research is needed to confirm the same, we asked an expert to shed light on it.
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How Lupus Symptoms Change With Age
According to Gaurav Prakash Bhardwaj, Director - Sports Injury, Joint Preservation and Replacement Surgery, PSRI Hospital, New Delhi, lupus, or Systemic Lupus Erythematosus (SLE), is a chronic autoimmune disease that often follows an unpredictable course.
"As patients grow older, the disease may progress differently for each individual," he said.
While some patients may experience fewer flare-ups, others continue to have active disease with organ involvement. "With age, cumulative organ damage caused by inflammation, medications (such as steroids), and other comorbidities like hypertension or diabetes becomes more noticeable. Many patients find that while acute flares may become less aggressive, long-term complications such as osteoporosis, cardiovascular disease, or kidney damage can remain significant concerns," he added.
What Does Research Say?
The recent study published in Science Translational Medicine looked at how ageing affects lupus compared to healthy individuals. Normally, ageing is linked with more inflammation and a higher risk of chronic illnesses. But in people with lupus, the researchers noticed something different; older patients actually showed lower disease activity as they aged.
By studying blood samples from nearly 300 lupus patients and more than 900 healthy people, they found that ageing in lupus patients was tied to reduced activity of interferon (a key immune pathway that drives lupus), lower levels of interferon proteins in the blood, and changes in gene regulation through DNA methylation.
The team also found that while both groups naturally lost naïve T cells with age (a normal part of immune ageing), lupus patients uniquely developed higher levels of certain natural killer cells. Interestingly, many of the genes that were both switched off and chemically silenced with ageing in lupus were interferon-related, suggesting that ageing itself may 'turn down' the overactive immune system in these patients.
In simple terms, the study shows that while ageing usually makes the immune system weaker and more inflamed, in lupus it may actually calm the disease by dampening the very signals that drive it.
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Do Lupus Symptoms Really Become Milder With Age?
"For many patients, lupus symptoms may change rather than simply becoming milder. Younger patients often experience more aggressive flares involving the kidneys, skin, and joints. As patients age, lupus may shift toward more chronic manifestations, such as persistent fatigue, joint stiffness, or cardiovascular risks," explained Dr Bharadwaj.
However, according to the doctor, the severity varies greatly, and some individuals may still experience significant flares later in life. “It is also important to note that treatment advances have improved long-term disease control, which can help reduce flare intensity in older age groups,” he added.
Management Tips For Lupus
While lupus has no cure, it can be managed with various strategies, depending on the patient's age and overall health.
“In younger patients, the focus is often on controlling inflammation aggressively to prevent long-term organ damage. In middle age, attention shifts to balancing disease control with minimizing medication side effects. For older patients, management may emphasize preventing complications such as osteoporosis, heart disease, and infections,” Dr Bharadwaj shared.
He concluded, “Across all ages, maintaining a healthy lifestyle is crucial. This includes regular exercise, a balanced diet, adequate sleep, sun protection, and stress management. Patients should also work closely with their doctors for regular check-ups and timely medication adjustments.”