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Background: Limited studies have explored the impact of arthritis, other medical illnesses on morale in the elderly. Our study is aim to assess the association between arthritis and morale among Chinese nonagenarians and centenarians. Methods: This work was conducted as a cross-sectional study. The presence of arthritis, other medical illnesses was based on the subjects' report of diagnoses as told by their doctors and medical records from the investigation. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to measure morale. Low morale was defined as PGCMS score < 10. Results: Our population included 650 unrelated Chinese nonagenarians and centenarians (67.3% women, mean age 93.5 years). The mean (SD) PGCMS score for the sample was 12.2 (2.9), and the prevalence of arthritis was 34%. After adjustment for potential confounders, multiple logistic regressions demonstrated that arthritis is associated with low morale among Chinese nonagenarians and centenarians (OR = 2.079, 95% CI 1.293 to 3.343). Conclusion: Our study demonstrates that R1.5 arthritis may be associated with low morale among Chinese nonagenarians and centenarians.