A Field Whose Time Has Come: Launching the EULAR Study Group on Geriatric Rheumatology Save

The demographics of rheumatology have changed faster than our evidence base. A substantial portion of patients seen in rheumatology clinics are now older adults living with multimorbidity, polypharmacy, frailty, cognitive impairment, functional limitation, and competing health priorities. Yet the studies and guidelines that shape our care still too often reflect a less complex and often younger patient than the patient in front of us. That mismatch is no longer a niche concern. It is everyday rheumatology.

This week at EULAR 2026 in London, the EULAR Study Group on Geriatric Rheumatology holds its inaugural meeting. The launch marks an important step for a field that has been visible in clinical practice, but less visible in professional structures. Geriatric rheumatology asks a practical question: how should rheumatology care change when the goal is not only inflammatory disease control, but also preserving mobility, independence, cognition, medication safety, and what matters most to older adults?

The groundwork for this moment has been building on both sides of the Atlantic. In the United States, a group of rheumatologists, geriatricians, and aging focused investigators began meeting regularly in 2023 to define shared priorities for the field. That effort helped catalyze a Lancet Rheumatology series on aging and rheumatic diseases, including papers on the 5Ms framework for rheumatologists, cognitive impairment, frailty, ageism, and palliative care. The aim was not to create a new silo, but to give rheumatologists a common language for the problems they already manage every day.

The work was transatlantic from the start. European colleagues, including Marloes van Onna and Bjoern Buehring, were part of that early scholarship and helped connect geriatric principles to rheumatology practice in a way that could resonate beyond national boundaries. EULAR approval of the Study Group now gives this work a formal European home. The group is chaired by Dr. Marloes van Onna of the Maastricht University Medical Center (the Netherlands), with Drs. Bjoern Buehring (Berlin, Germany) and Una Makris (San Diego, USA) as co chairs, and includes rheumatologists, elderly care physicians, nurse specialists, physiotherapists, and patient representatives from across Europe.

“I am really happy that we can now officially start this new EULAR Study Group. The population is ageing globally at a fast pace and we need to get ready for this silver wave. I am especially proud that our collaboration is transatlantic from day one and that we share a common goal: to improve care for our ageing patients with rheumatic diseases. I look forward to the many projects that we will work on together.” - Dr. Marloes van Onna, Chair, EULAR Study Group on Geriatric Rheumatology

The first task of the EULAR Study Group is appropriately foundational. Before the field can write recommendations, it needs to define the gaps. Where are older adults being excluded from research? Which outcomes matter most to patients, caregivers, and care partners? How should frailty, cognition, function, and treatment burden be measured in rheumatology studies? How should clinicians adapt disease management when trial evidence is thin, competing conditions are common, and medication harms can be as consequential as disease activity?

EULAR 2026 offers several signs that the field is ready for this conversation. Sessions on sarcopenia, malnutrition, osteoporosis, frailty, menopause, muscle fitness, caregivers, and older adults in RMD research are woven through the program. The program also includes work on inclusion of older adults in pharmacologic trials and functional vulnerability in older people with rheumatoid arthritis. These are not side issues. They shape treatment decisions, safety monitoring, shared decision making, rehabilitation, and the outcomes patients actually experience. For RheumNow readers, the message is simple: aging belongs in the center of rheumatology science, not at its margins.

A parallel effort is also underway in the United States. The American College of Rheumatology recently received support from the Council of Medical Specialty Societies, funded by the John A. Hartford Foundation, to adapt the Age Friendly Health Systems 4Ms framework, What Matters, Medication, Mentation, and Mobility, into rheumatology practice. This initiative will develop a Rheumatology Age-Friendly 4Ms Care Guide across diverse ambulatory practices. While this work is separate from the EULAR Study Group, both efforts point to the same broader need: bringing geriatric principles into everyday rheumatology care. As the field grows, there may be valuable opportunities for shared learning across health systems.

Geriatric rheumatology is not a subspecialty for later. The demographics of our patients have already made it the everyday reality of rheumatology practice. The launch of the EULAR Study Group gives the field a timely opportunity to organize, collaborate, and ask a better question: not simply how to treat rheumatic disease in older adults, but how to deliver care that protects health, function, independence, and dignity as people age with rheumatic disease.