Mild cognitive impairment and rheumatoid arthritis

AbstractBackgroundIncreasing evidence from the last ten years suggests that systemic inflammation may be associated with an increased risk of developing Alzheimer’s disease (AD). Some studies have found an association between rheumatoid arthritis (RA) and neurodegeneration with several finding increased incidence of mild cognitive impairment (MCI) in those with RA compared to healthy controls. This study aims to use preliminary data from the Rheumatoid arthritis, medication and memory study (RESIST) to investigate the prevalence of MCI in a population of patients with RA and explore the relationship between MCI and specific demographic and clinical characteristics.MethodThe Montreal Cognitive Assessment (MoCA) was used as a cognitive screening tool and was administered to subjects who were ≥55 years of age and had been diagnosed with RA according to the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria. Demographic and clinical data was recorded at screening in face‐to‐face interviews and included age, gender, type of RA medication and date of RA diagnosis. 260 participants completed both screening and baseline visits as part of the RESIST longitudinal study, MoCA scores from baseline were analysed for these participants. Statistical analysis was used to provide descriptive statistics for our population and determine predictors of cognitive impairment.ResultA total of 636 participants (mean age 68.1, 67.5% female) were screened between May 2018 and December 2019. The mean MoCA for screened participants was 25.4, 45.3% of our population scored <26 in the MoCA and were considered cognitively impaired. Age was negatively correlated to MoCA score and was the only significant predictor of cognitive impairment (p<0.001). Gender, type of RA medication and duration of disease did not contribute to the regression model. The mean MoCA score was found to differ by 0.404 points between screening and baseline.ConclusionA large proportion of our participants scored below the proposed cut‐off for normal cognition in the MoCA suggesting at the high prevalence of MCI in older adults with RA. This may provide further support for the role of chronic inflammation in AD and questions whether it would be worthwhile introducing routine screening for MCI in rheumatology clinics.