Assessment of Cognitive Impairment in Rheumatoid Arthritis.

Objective: The objectives of our study were to assess the prevalence of cognitive impairment in Rheumatoid arthritis (RA) and to identify its predictive factors.

Methods: A 6-month cross-sectional case-control study englobing patients with RA was carried out. The cognitive evaluation was performed using the Mini Mental State Examination (MMSE), the frontal efficiency battery, the 5-word test, the clock drawing test and the Trail Making Test part-A (TMT-A). Linear regression analyses were conducted to identify predictors of cognitive impairment.

Results: We included 35 RA patients and 35 controls. Concerning the RA group, the mean duration of the disease was 12.3 years [1-29 years]. RA was immunopositive in 80% of cases and erosive in 83% of cases. The global cognitive dysfunction assessed by MMSE score was 49%. Depending on the test used, the prevalence of cognitive impairment in RA ranged from 34% to 54%. RA patients presented poorer results regarding the TMT-A than the controls (p = 0.03). The other cognitive tests were comparable between the 2 groups. The main predictive independent factors of cognitive impairment among RA patients were advanced age (p = 0.002), rural environment (p = 0.007), low income (p = 0.01), recent course of RA (p = 0.006), low disease activity (p = 0.002) and low blood sugar (p = 0.003).

Conclusion: Global cognitive impairment in RA concerned 49% of our patients. Early identification of the factors associated with this cognitive dysfunction is necessary in order to improve the quality of life of patients.