Related Experiment Video
Updated: Sep 17, 2025
An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
Published on: June 6, 2025
Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis
Jun Yan1, Hua Guo1, Lin-Xin Zhang2
1Department of Neurology, Xi'an Fifth Hospital, Xi'an, Shaanxi Province, China.
Background:
Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint destruction and systemic inflammation, both of which significantly impair patients' quality of life. Mild cognitive impairment (MCI), a reversible precursor to dementia, is increasingly prevalent among elderly RA patients. Early identification of MCI in this population allows for timely interventions to slow cognitive decline.
Objective:
This study aims to identify independent risk factors for MCI in elderly patients with RA and to develop a predictive nomogram.
Methods:
We enrolled 378 elderly RA patients, aged 60 to 80 years, from Xi'an Fifth Hospital between December 2023 and December 2024. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with scores ranging from 20 to 26 indicating MCI. We analyzed demographic, clinical, and laboratory data to identify risk factors through logistic regression and constructed a nomogram. The model's performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).
Results:
Among the 378 patients, 94 (24.87%) were classified in the RA-MCI group. Multivariate analysis identified the course of disease (COD) (OR = 1.07, 95% CI: 1.03-1.10), elevated Disease Activity Score-28 (DAS28) (OR = 1.31, 95% CI: 1.13-1.53), high C-reactive protein (CRP) levels (OR = 1.01, 95% CI: 1.01-1.02), and osteoporosis (OP) (OR = 1.88, 95% CI: 1.14-3.13) as independent risk factors. The nomogram demonstrated moderate discrimination (AUC = 0.750, 95% CI: 0.696-0.805) and clinical utility.
Conclusion:
The COD, OP, DAS28, and CRP levels are key predictors of MCI in elderly RA patients. The proposed nomogram provides a practical tool for early risk stratification, facilitating targeted interventions to delay cognitive decline.
Trial Registration:
This study conformed to the principles outlined in the Declaration of Helsinki and received approval from the Medical Ethics Committee of Xi'an Fifth Hospital (Approval No.: [2023] Ethics Review 55). Additionally, the trial was registered with the Chinese Clinical Trial Registry (Registration No.: ChiCTR2300077337, Registration Date: 2023-11-01). Written informed consent was obtained from all individual participants included in the study.
Insights
Longer disease duration, higher inflammation (DAS28, CRP), and osteoporosis increase mild cognitive impairment risk in elderly rheumatoid arthritis patients. A predictive nomogram aids early detection for timely intervention.
Area of Science:
- Rheumatology
- Geriatrics
- Neuroscience
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint damage and systemic inflammation, impacting quality of life.
- Mild cognitive impairment (MCI), a precursor to dementia, is increasingly observed in elderly RA patients.
- Early identification of MCI in RA patients is crucial for timely interventions to mitigate cognitive decline.
Purpose of the Study:
- To identify independent risk factors for MCI in elderly RA patients.
- To develop a predictive nomogram for MCI risk stratification in this population.
Main Methods:
- 378 elderly RA patients (60-80 years) were assessed for cognitive function using the Montreal Cognitive Assessment (MoCA).
- MCI was defined as MoCA scores between 20-26.
- Logistic regression and nomogram construction were used to identify risk factors and predict MCI, with model performance validated by ROC curves, calibration plots, and DCA.
Main Results:
- 94 out of 378 patients (24.87%) had RA-MCI.
- Independent risk factors for MCI included longer disease duration (COD), elevated Disease Activity Score-28 (DAS28), high C-reactive protein (CRP) levels, and osteoporosis (OP).
- The developed nomogram showed moderate predictive discrimination (AUC=0.750).
Conclusions:
- Disease duration, osteoporosis, DAS28, and CRP levels are significant predictors of MCI in elderly RA patients.
- The nomogram serves as a practical tool for early risk assessment.
- Targeted interventions based on this tool can help delay cognitive decline in RA patients.
More Related Videos
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:11Genome-wide Association Studies-GWAS
GWAS does not require the identification of the target gene involved in...
01:23Rheumatic Heart Disease I: Introduction
01:20Rheumatic Heart Disease IV: Nursing Management
01:21Rheumatic Heart Disease III: Medical Management
01:30Coronary Artery Disease I: Introduction