Objectives <p>Rheumatic diseases are prevalent chronic conditions among older adults. This study investigates the associations between four dietary patterns, including anti-inflammatory diet (AID), protein-enriched diet (PED), Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and plant-based diet (PBD), and the prevalence of rheumatic diseases in older Chinese populations.</p> Method <p>Data for this study were derived from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey. Logistic regression was employed to analyze the associations between AID, PED, MIND, PBD, and the prevalence of rheumatic diseases. Additionally, the study employed a series of analytical techniques, including Restricted Cubic Spline (RCS) analysis and subgroup analysis to ensure the robustness of our findings.</p> Results <p>A total of 5240 participants were included in this cross-sectional survey analysis. After controlling all covariates included, per one-score increase in the AID was associated with a 13.7% lower prevalence of rheumatic diseases (OR = 0.863, 95% CI: 0.775–0.959, <i>P</i> = 0.007), and per one-score increase in the MIND was associated with a 12.4% lower prevalence (OR = 0.876, 95% CI: 0.813–0.943, <i>P</i> &lt; 0.001). RCS analysis showed a linear relationship between AID, MIND, and the prevalence of rheumatic diseases. Furthermore, both AID and MIND were associated with a lower prevalence of rheumatic diseases in individuals with low muscle mass.</p> Conclusions <p>Higher adherence to AID and MIND diets, and the maintenance of normal muscle mass, were associated with a lower prevalence of general self-reported rheumatic diseases in older adults. However, their associations with specific rheumatic subtypes remain to be further explored.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> <p><b>Key Points</b></p> <p>•&#xa0;<i>Among older Chinese adults, AID and MIND diets are associated with a lower prevalence of general self-reported rheumatic diseases.</i></p> <p>• <i>Specific food groups within the AID and MIND, such as fresh fruits and legumes, are associated with a lower prevalence of general self-reported rheumatic diseases.</i></p> <p>• <i>Adherence to AID and MIND diets is associated with lower general self-reported rheumatic disease prevalence in individuals with low muscle mass.</i></p> </entry> </row> </tbody> </tgroup> </Table></p>