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Prevalence and factors associated with cognitive impairment in rheumatoid arthritis patients: a cross-sectional study
Rudy Hidayat1,2, Dian Azzahra3, Suryo Anggoro Kusumo Wibowo1,2
1Rheumatology Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Introduction:
Rheumatoid arthritis (RA) is a systemic autoimmune disease which has been associated with an increased risk of cognitive impairment. The objective of this study was to determine the prevalence and possible predictors of cognitive impairment in a cohort of RA individuals.
Material And Methods:
A cross-sectional study was conducted among RA patients aged ≥ 18 years visiting our rheumatology clinic. Demographic, clinical, and laboratory data were collected. Cognitive function was assessed using the Montreal Cognitive Assessment-Indonesian (MoCA-INA) questionnaire. The subjects were classified as cognitively impaired if they scored less than 26. Bivariate and multivariate logistic regression analyses were performed to identify predictive factors of cognitive impairment.
Results:
A total of 204 participants were included in the analysis, with a mean age of 48.60 (SD ±12.19) years. The prevalence of cognitive impairment based on MoCA-INA scores was 54.9%, with an overall median MoCA-INA score of 25 (range: 3-30). Subjects in the cognitively impaired group scored significantly lower in nearly all the MoCA domains: visuospatial/executive, naming, attention, delayed recall, abstraction, and language. Based on the multivariate analysis, it was found that older age (OR = 1.045, 95% CI: 1.018-1.073, p = 0.001), low education level (OR = 2.260, 95% CI: 1.153-4.432, p = 0.018), intermediate education level (OR = 3.161, 95% CI: 1.359-7.353, p = 0.008) education level, and glucocorticosteroid (GC) use (OR = 2.147, 95% CI: 1.133-4.070, p = 0.019) were significant predictors of cognitive impairment in this study.
Conclusions:
Cognitive impairment was identified in 54.9% of RA patients in this study. Older age, lower education levels, and GC use were significantly associated with increased risk of cognitive impairment.
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