Cognitive deficits early in the course of rheumatoid arthritis

Rheumatoid Arthritis (RA) is a form of arthritis characterized by joint pain, stiffness, swelling and deformity. There has been plethora of researches in the area of rheumatoid arthritis which focused on immune system, genetic predisposition and newer treatment modalities. Researchers have also examined the cognitive decline, physical deficits and their interrelationship in patients with RA. Among several psychological aspects depression, anxiety and stress emerge as significant psychological co morbidity. RA is a multifactorial, chronic, inflammatory disease primarily affects physical functioning as well as psychological aspects. Pain, fatigue, duration of disease, disease activity and functional disability are very common in rheumatoid arthritis which is leading cause of psychological distress and functional disability. Various types of neuropsychological battery were used to assess the decline in specific areas like attention, executive functioning, visuo-spatial learning, verbal learning/memory etc. These functions were compared with other type of arthritis disease. Also, various other factors like depression, cardiovascular diseases, other systemic and chronic disease and concomitant drugs intake etc. also affected cognitive functioning in Rheumatoid Arthritis patients. The objective of this review was to identify and explore the rates and types of cognitive impairment in RA. This present review paper systematically examines and summarizes the cognition related decrement in arthritis patients. Multiple research articles between 1990 to 2018 were searched. These reviews were evaluated and synthesized using a narrative and descriptive approach.

show abstract

“…It is assumed that cognitive impairment leads to decrease in performance in physical activity and other executive functioning. [ 21 ]…”

Section: Introductionmentioning

confidence: 99%

Cognitive dysfunction in patients of rheumatoid arthritis

Chaurasia

Singh

et al. 2020

J Family Med Prim Care

View full text Add to dashboard Cite

show abstract

“…It affects reactivity to pain, compliance to and effectiveness of therapy [1]. This CD may occur early, in young RA patients, even in the early stages of the disease [9]. In general, CD may influence daily activities, treatment compliance and overall self-care [1,2].…”

Section: Introductionmentioning

confidence: 99%

Cognitive dysfunction in autoimmune rheumatic diseases

Oláh¹,

Schwartz

Denton

et al. 2020

Arthritis Res Ther

View full text Add to dashboard Cite

For people with chronic autoimmune rheumatic diseases (AIRD), such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or systemic sclerosis (SSc), normal cognitive functions are essential for performing daily activities. These diseases may be associated with cognitive dysfunction (CD). In RA, CD has been associated with age, lower education and disease duration and activity. Great advances have been achieved in neuropsychiatric SLE in the identification of pathogenic pathways, assessment and possible treatment strategies. SSc rarely exerts direct effects on the brain and cognitive function. However, the psychological burden that includes depression, anxiety and social impact may be high. AIRD patients with sustained disease activity, organ damage or lower education should be evaluated for CD. The control of systemic inflammation together with tailored behavioural cognitive therapies may benefit these patients.

show abstract

“…5 Several studies suggest that comorbidities, 6 including depression and anxiety, influence physical impairment in MS. 7 Prior studies also suggest that depression influences cognition in MS, although findings have been inconsistent. 8,9 While recent studies have suggested that anxiety is associated with impaired information processing speed in MS, 10 few have jointly assessed the effects of depression and anxiety on cognition in MS. 5 Moreover, it is uncertain whether the nature and magnitude of the effects of depression and anxiety on cognition in MS are the same as observed in other IMID without direct CNS involvement, [11][12][13] or the same as for persons with depression and anxiety without an IMID. 14 Such knowledge is of interest given the potential role of inflammation in psychiatric disorders including depression and anxiety.…”

mentioning

confidence: 99%

Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo determine whether anxiety and depression are associated with cognition in multiple sclerosis (MS), and whether these associations are similar in other immune-mediated inflammatory diseases (IMID; including inflammatory bowel disease [IBD] and rheumatoid arthritis [RA]) and in anxious/depressed individuals (ANX/DEP) without an IMID.MethodsParticipants (MS: n = 255; IBD: n = 247; RA: n = 154; ANX/DEP: n = 308) completed a structured psychiatric interview, the Hospital Anxiety and Depression Scale, and cognitive testing, including the Symbol Digit Modalities Test, the California Verbal Learning Test, and Letter Number Sequencing test. Test scores were converted to age-, sex-, and education-adjusted z scores. We evaluated associations of anxiety and depression with the cognitive z scores using multivariate linear models, adjusting for disease cohort.ResultsAll cohorts exhibited higher rates of impairment (i.e., z less than or equal to −1.5) in the domains of processing speed, verbal learning, and delayed recall memory relative to general population norms. Higher levels of anxiety symptoms were associated with slower processing speed, lower verbal learning, and lower working memory performance (all p < 0.001); higher levels of depression symptoms were associated with slower processing speed. These associations did not differ across cohorts.ConclusionAnxiety and depression are associated with lower cognitive function in MS, with a similar pattern observed in persons with other IMID, including IBD and RA, and persons without an IMID. Managing symptoms of anxiety and of depression in MS, as well as other IMIDs, is important to mitigate their effect on cognition.

show abstract

Cognitive deficits early in the course of rheumatoid arthritis

Abstract: Cognitive deficits on several domains are frequently encountered in relatively young RA patients during the first few years of the disease and may need to be taken into account as important correlates of disease severity and progression.

Cited by 27 publications

References 29 publications

Cognitive dysfunction in patients of rheumatoid arthritis

Cognitive dysfunction in patients of rheumatoid arthritis

Cognitive dysfunction in autoimmune rheumatic diseases

Comorbid anxiety, depression, and cognition in MS and other immune-mediated disorders

Contact Info

Product

Resources

About