SAT0641-HPR FACTORS ASSOCIATED WITH COGNITIVE IMPAIRMENT IN KOREAN ADULTS WITH RHEUMATOID ARTHRITIS

Abstract

Background: For persons with chronic diseases including rheumatoid arthritis (RA), undamaged cognitive capacity is critical for daily functioning, treatment compliance, and self-management. Disease-specific features of RA such as systemic chronic inflammation or increased comorbid cardiovascular disease (CVD) risk may be closely linked to neurocognitive dysfunction in RA patients [1]. However, the evidence of brain involvement in RA is very rare or even controversial and very little is known about the pathogenic mechanisms of cognitive decline in persons with RA. Objective(s): This study explored the prevalence of cognitive impairment in Korean adults with RA using a set of computerized neurocognitive tests and the factors that were significantly associated with cognitive impairment. Method(s): Individuals with RA were recruited by their rheumatologists during follow-up visits at one university hospital in Korea. After getting signed consents, a trained research nurse assessed participants with a range of physical, psychosocial, and biological metrics. Cognitive function was assessed using a set of 6 computerized neurocognitive tests yielding 18 indices covering a range of cognitive domains. Subjects were classified as 'impaired' if they performed 1 SD below age-based population norms on each test [2]. The total cognitive function score was calculated by summing the transformed scores, ranging from 0 (no impairment) to 18 (worst impairment). Multiple linear regression analyses were conducted to identify the significant factors influencing cognitive impairment. Result(s): Sixty five subjects with a mean (+/-SD) age of 61.9 (+/-10.0) years were included. 85% were female, 89% were married, and 76% had less 12 years of education. Mean disease activity score (DAS-28) was 2.3 (+/-1.3) and mean disease duration was 9.8 (+/-8.7) years. Mean functional limitations score (HAQ) was 0.3 (+/-0.5) and mean CVD risk factors were 2.3 (+/-1.5). Total cognitive function score was 11.1 +/- 4.0 (2-18). The proportion of persons who were classified as cognitively impaired on each test ranged from 25% to 92%. The proportion of persons classified as cognitively impaired on the quarter of total subtests (5 or more out of 18 subtests) was 94%. The multivariate regression model was statistically significant and accounted for 39% of the variance in cognitive impairment (F=5.26, p