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Cognitive impairment was found to be a common
association in RA patients. Prevalence rates and types of CI will be confirmed
in future studies.
Rheumatoid arthritis (RA) is a disorder related to chronic
pain and inflammation in joints of the body. It is not commonly linked to the central nervous system and brain
changes. However, some studies conducted on RA have reported high rates of
cognitive impairment (CI) in adults with RA. This systematic review aimed to
recognize and inspect the rates and types of CI in RA.
Multiple databases were explored within a time frame
between 1994 to 2016 to acknowledge studies that have included: (i) adults with
RA; (ii) standardized neuropsychological tests; and (iii) sufficient
information to ascertain the relationship between CI and demographic, clinical
and psychological factors. Out of 1,980 titles considered, 75 were retained at
the abstract level, 36 at the full-text level and 15 studies in the final
review. Then an assessment was made using a modified Newcastle-Ottawa
Evaluation Scale, and the findings were synthesized using a narrative approach.
Results indicated that 10 out of 15 studies compared RA to other clinical and/or control groups. Based on summed effect size analyses, individuals with RA significantly underperformed on cognitive function tests as compared to the control groups; particularly on verbal function, memory and attention. Less clear differences were found between RA and other clinical groups. Some factors like demographics (age, education), clinical (disease activity) and psychological (depression) were found to be linked with CI but inconsistently so across studies. The limitations included a small and predominantly female sample, limited cognitive domain inclusion, lack of study details and management of confounding variables.
Overall, it was concluded that there exists some evidence
for CI prevalence in adults with RA, but further studies are needed to confirm
prevalence rates and examine potential mechanisms.
Arthritis Care & Research
Cognitive Impairment in Rheumatoid Arthritis: A Systematic Review
Tanya Meade et al.
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