- Mena-Vázquez N. et al. Impact of inflammation on cognitive function in patients with highly inflammatory rheumatoid arthritis. DOI.org/10.1136/rmdopen-2024-004422 RMD Open 2024;10.
Not only do the joints suffer from chronic inflammation in rheumatism, but cognitive function also seems to be affected by the disease: a recent study (DOI.org/10.1136/rmdopen-2024-004422) examined the extent to which patients with moderately to highly active RA suffer from cognitive impairment. The results show that around 60 per cent of patients with moderate to severe RA suffer from cognitive deficits, compared to only 40 per cent of a healthy control group. Visual memory, abstract thought processes and executive functions (e.g. working memory) were particularly affected, as tests with the MoCA (Montreal Cognitive Assessment) showed.
The researchers found that there is a significant correlation between the level of inflammatory activity and cognitive deficits within the group with RA. The average CRP and IL-6 values of patients with cognitive deficits were significantly higher than in those without cognitive impairments. This suggests that systemic inflammation could damage not only the joints but also the brain.
But it is not only in terms of inflammatory activity that the two groups of rheumatic patients differ: compared to those without cognitive impairments, patients with such impairments were older, had a lower level of education and more frequently exhibited comorbidities such as obesity, dyslipidaemia and arterial hypertension.
Executive functions and the ability to think abstractly and spatially were particularly affected. These thought processes are essential for everyday life as they influence the ability to plan and organise complex tasks. Memory performance was also significantly worse than that of the control group, with deficits in the storage and retrieval of information being observed.
Cognitive impairment in patients with RA may be based on several factors. For example, it has been suggested that neuroinflammation and endocrine dysfunction, among other things, may contribute to cognitive impairment. In addition, the effects of RA, such as chronic pain and fatigue, can also have a negative impact on cognition.
Cognitive impairment is an underrated consequence of rheumatoid arthritis. The available research results show that increased inflammatory activity can significantly increase the risk of cognitive deficits. The study data also emphasise the importance of early and consistent control of inflammatory activity in RA patients. Rapid implementation of anti-inflammatory therapies could potentially not only improve patients' quality of life but also maintain their independence in everyday life for longer.