The following is a summary of “Risk Factors for Dementia in Patients With Incident Rheumatoid Arthritis: A Population-Based Cohort Study,” published in the January 2023 issue of Rheumatology by Kodishala, et al.
A growing body of research indicates that people with rheumatoid arthritis (RA) are more likely to develop dementia. In an initial group of RA patients, researchers analyzed predisposing factors for dementia. Residents of 8 counties in Minnesota who fulfilled the 1987 American College of Rheumatology criteria for incident RA between 1980 and 2014 were enrolled in this retrospective population-based cohort study and were tracked until death/migration or December 31, 2019. Dementia patients were ruled out before the onset of RA. Dementia was considered to have occurred when two different ICD-9 or ICD-10 version codes were observed during a 30-day period.
Population data, disease details, cardiovascular/cerebrovascular disease (CVD) risk factors, and co-morbidities were all gleaned from patient charts. Investigators examined data from 886 RA patients (mean age 65.1%, 65.2% female). A study of 886 patients with RA was conducted, with a mean age of 65.1 years and 65.2% of them being female. During the follow-up period, which was a median of 8.5 years, 103 patients developed dementia. After data were adjusted for age, sex, and RA incidence, it was found that older age at RA incidence (HR 1.14 per 1 year increase, 95% CI 1.12-1.17), presence of rheumatoid nodules (HR 1.76, 95% CI 1.05-2.95), hypertension (HR 1.84, 95% CI 1.19-2.85), large joint swelling (HR 2.03, 95% CI 1.14-3.60), any CVD (HR 2.25, 95% CI 1.38-3.66), ischemic stroke (HR 3.16, 95% CI 1.84-5.43), heart failure (HR 1.82, 95% CI 1.10-3.00), anxiety (HR 1.86, 95% CI 1.16-2.97), and depression (HR 2.63, 95% CI 1.76-3.93) were all associated with an increased risk of developing dementia.
All of the above covariates were substantially linked with the risk of dementia after controlling for CVD risk factors and any CVD. Clinically active RA and the presence of CVD were associated with an increased risk of dementia incidence among patients with RA, in addition to age, hypertension, depression, and anxiety, all of which are well-known risk factors for dementia.