Reduced cognitive ability in people with rheumatoid arthritis compared with age-matched healthy controls

Objectives: To compare the cognitive ability of people with rheumatoid arthritis (RA) with healthy controls (HCs). Methods: People with RA were recruited from the Norfolk Arthritis Register (NOAR), a population-based cohort study of people with inflammatory arthritis. Data on aged-matched HCs (people with no cognitive impairment) came from the comparison arm of The Dementia Research and Care Clinic Study (TRACC). People with RA and HCs performed a range of cognitive ability tasks assessing: attention, memory, verbal fluency, language, visuospatial skills, emotional recognition, executive function and theory of mind. A score of <88 on the Addenbrooke’s Cognitive Examination-III (ACE-III) was considered cognitive impairment. Scores were compared using linear regression adjusting for age, gender, smoking status, education, body mass index, anxiety and depression. Results: Thirty-eight people with RA (mean [standard deviation (SD)] age: 69.1 [8.0]; 25 [65.8%] women) were matched with 28 HCs (mean [SD] age: 68.2 [6.4]; 15 [53.6%] women). Twenty-three (60.5%) people with RA were considered to have mild cognitive impairment (mean [SD] ACE-III: RA = 85.2 [7.4], HC = 96.0 [2.5]). People with RA had impairments in memory, verbal fluency, visuospatial functioning, executive function, and emotional recognition in faces compared with HCs, after adjustment for confounders. Conclusions: People with RA had cognitive impairments in a range of domains. People with RA may benefit from cognitive impairment screening to allow for early administration of appropriate interventions.