Cognitive Functional Impairment Associated With Physical Function and Frailty in Older Patients With Rheumatoid...

Cognitive function is crucial for comprehending, adhering to, and terminating treatment regimens, and for maintaining quality of life in individuals with rheumatoid arthritis (RA). This study aimed to investigate the factors associated with cognitive functional impairment in Japanese patients with RA.

A total of 452 patients with RA, aged 65 years and older, were enrolled in this study. We examined cognitive functional impairment using the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8), frailty using the Kihon Checklist (KCL), and clinical data. We defined cognitive functional impairment as a DASC-8 score ≥ 11. Patients were categorized into three groups based on the total KCL scores: robust (0-3), pre-frailty (4-7), and frailty (≥ 8).

The prevalence of cognitive functional impairment was 26.5%. Using multivariate logistic regression analysis, factors associated with cognitive functional impairment included age (p = 0.046), Health Assessment Questionnaire-Disability Index score (p < 0.001), and KCL score (p < 0.001). The frailty rates in the groups with and without cognitive functional impairment were 85.0% and 28.6%, respectively (p < 0.001).

The study findings suggest that cognitive functional impairment is more likely to occur with age, as aging is a factor associated with cognitive impairment. Our findings highlight the importance of assessing cognitive ability in older patients with RA, particularly the elderly, who should receive management for cognitive function alongside RA disease activity, physical function, and frailty in their treatment plan.