Table Info

Table 6.

Estimated ORs of SCD* based on logistic regression models (age ≥ 55)**

CDAI	Unadjusted		Model 1		Model 2		Model 3		Model 4		Model 5
CDAI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Remission	Ref		Ref		Ref		Ref		Ref		Ref
Low	2.33	1.99–2.73	1.94	1.66–2.27	1.90	1.62–2.23	1.73	1.48–2.04	1.11	0.94–1.30	1.08	0.92–1.28
Moderate	3.57	3.20–4.39	2.80	2.38–3.29	2.67	2.27–3.14	2.29	1.94–2.70	1.27	1.07–1.51	1.21	1.01–1.44
Severe	5.44	4.61–6.42	3.59	3.03–4.26	3.37	2.83–4.01	2.80	2.35–3.35	1.31	1.09–1.58	1.24	1.03–1.51

* SCD determined with patient self-report of difficulty thinking and confusion; ** log(π/(1 – π)) = β₀ + β₁ × Agelt55 + β₂ × LDA + β₃ × moderate + β₄ × severe + β₅ × Agelt55 × LDA + β₆ × Agelt55 × moderate + β₇ × Agelt55 × severe, where π is the probability of SCD; Agelt55 is an indicator (0/1) of age < 55; and LDA, moderate, and severe are indicators (0/1) of CDAI levels (age > 55 and CDAI remission are reference groups)

Supplementary materials

The supplementary material for this article is available at: https://www.explorationpub.com/uploads/Article/file/100725_sup_1.pdf.

Declarations

Acknowledgments

The authors would like to thank all the participating investigators and patients in the CorEvitas Rheumatoid Arthritis Registry who contributed data for this study.

Author contributions

OP, DAP, and JMK equally contributed to: Conceptualization, Data curation, Formal analysis, Writing—original draft, Writing—review & editing, Supervision. GR: Conceptualization, Formal analysis, Writing—original draft, Writing—review & editing, Supervision. LRH: Conceptualization, Data curation, Writing—original draft, Writing—review & editing, Supervision.

Conflicts of interest

DAP has equity interests and is an employee of CorEvitas (formerly known as Corrona), is a member of the Board of Directors of the Corrona Research Foundation (CRF), and has received honoraria/consulting fees from Novartis, Sanofi, Genentech, Roche, and Abbvie. GR is a consultant for Corrona Research Foundation and CorEvitas, LLC. LRH is an employee and stockholder of CorEvitas and has received honoraria/consulting feeds from AbbVie, Bristol-Myers Squibb, and Roche, on the speaker’s bureau for Bristol-Myers Squib, and received grant funding from Pfizer. JMK is the president of the Corrona Research Foundation where he serves in a non-remunerative position. He is also a consultant for CorEvitas.

Ethical approval

Sponsor approval and continuing review were obtained through a central IRB (New England Independent Review Board, NEIRB No. 120160610) and complied with the Declaration of Helsinki.

Consent to participate

Informed consent to participate in the study was obtained from all participants.

Consent to publication

Not applicable.

Availability of data and materials

Data are available from CorEvitas, LLC through a commercial subscription agreement and are not publicly available. Additional aggregated data are available from the authors.

Funding

This study was funded by the Corrona Research Foundation. The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Copyright

References

Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018;4:18001. [DOI] [PubMed]

Appenzeller S, Bertolo MB, Costallat LT. Cognitive impairment in rheumatoid arthritis. Methods Find Exp Clin Pharmacol. 2004;26:339–44. [DOI] [PubMed]

Bartolini M, Candela M, Brugni M, Catena L, Mari F, Pomponio G, et al. Are behaviour and motor performances of rheumatoid arthritis patients influenced by subclinical cognitive impairments? A clinical and neuroimaging study. Clin Exp Rheumatol. 2002;20:491–7. [PubMed]

Shin SY, Katz P, Wallhagen M, Julian L. Cognitive impairment in persons with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2012;64:1144–50. [DOI] [PubMed] [PMC]

Simos P, Ktistaki G, Dimitraki G, Papastefanakis E, Kougkas N, Fanouriakis A, et al. Cognitive deficits early in the course of rheumatoid arthritis. J Clin Exp Neuropsychol. 2016;38:820–9. [DOI] [PubMed]

Booth MJ, Janevic MR, Kobayashi LC, Clauw DJ, Piette JD. No association between rheumatoid arthritis and cognitive impairment in a cross-sectional national sample of older U.S. adults. BMC Rheumatol. 2021;5:24. [DOI] [PubMed] [PMC]

Meade T, Manolios N, Cumming SR, Conaghan PG, Katz P. Cognitive impairment in rheumatoid arthritis: a systematic review. Arthritis Care Res (Hoboken). 2018;70:39–52. [DOI] [PubMed]

McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011;365:2205–19. [DOI] [PubMed]

Gorelick PB. Role of inflammation in cognitive impairment: results of observational epidemiological studies and clinical trials. Ann N Y Acad Sci. 2010;1207:155–62. [DOI] [PubMed]

10.

Szekanecz Z, Kerekes G, Dér H, Sándor Z, Szabó Z, Végvári A, et al. Accelerated atherosclerosis in rheumatoid arthritis. Ann N Y Acad Sci. 2007;1108:349–58. [DOI] [PubMed]

11.

Katchamart W, Narongroeknawin P, Phutthinart N, Srinonprasert V, Muangpaisan W, Chaiamnauy S. Disease activity is associated with cognitive impairment in patients with rheumatoid arthritis. Clin Rheumatol. 2019;38:1851–6. [DOI] [PubMed]

12.

Lee JH, Kim GT, Kim YK, Lee SG. Cognitive function of patients with rheumatoid arthritis is associated with disease activity but not carotid atherosclerotic changes. Clin Exp Rheumatol. 2018;36:856–61. [PubMed]

13.

Shadick NA, Katz P, Iannaccone CI, Maica G, Coblyn J, Weinblatt ME, et al. The impact of exercise, lifestyle, and clinical factors on perceived cognitive function in patients with rheumatoid arthritis: results from a prospective cohort study. ACR Open Rheumatol. 2019;1:620–6. [DOI] [PubMed] [PMC]

14.

Amariglio RE, Becker JA, Carmasin J, Wadsworth LP, Lorius N, Sullivan C, et al. Subjective cognitive complaints and amyloid burden in cognitively normal older individuals. Neuropsychologia. 2012;50:2880–6. [DOI] [PubMed] [PMC]

15.

Reisberg B, Prichep L, Mosconi L, John ER, Glodzik-Sobanska L, Boksay I, et al. The pre-mild cognitive impairment, subjective cognitive impairment stage of Alzheimer’s disease. Alzheimers Dement. 2008;4:S98–108. [DOI] [PubMed]

16.

Subjective cognitive decline — a public health issue [Internet]. Atlanta (GA): Centers for Disease Control and Prevention; c2018 [cited 2019 Jul]. Available from: https://www.cdc.gov/aging/data/subjective-cognitive-decline-brief.html

17.

Kremer JM. The Corrona US registry of rheumatic and autoimmune diseases. Clin Exp Rheumatol. 2016;34:S96–9. [PubMed]

18.

Aletaha D, Nell VP, Stamm T, Uffmann M, Pflugbeil S, Machold K, et al. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther. 2005;7:R796–806. [DOI] [PubMed] [PMC]

19.

Wallin K, Solomon A, Kåreholt I, Tuomilehto J, Soininen H, Kivipelto M. Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later: a population-based study. J Alzheimers Dis. 2012;31:669–76. [DOI] [PubMed]

20.

Shin SY, Katz P, Julian L. Relationship between perceived cognitive dysfunction and objective neuropsychological performance in persons with rheumatoid arthritis. Arthritis Care Res (Hoboken). 2013;65:481–6. [DOI] [PubMed] [PMC]

21.

Rathbun AM, England BR, Mikuls TR, Ryan AS, Barton JL, Shardell MD, et al. Relationship between depression and disease activity in United States veterans with early rheumatoid arthritis receiving methotrexate. J Rheumatol. 2021;48:813–20. [DOI] [PubMed] [PMC]

22.

Rathbun AM, Reed GW, Harrold LR. The temporal relationship between depression and rheumatoid arthritis disease activity, treatment persistence and response: a systematic review. Rheumatology (Oxford). 2013;52:1785–94. [DOI] [PubMed]

23.

Pezzato S, Bonetto C, Caimmi C, Tomassi S, Montanari I, Gnatta MG, et al. Depression is associated with increased disease activity and higher disability in a large Italian cohort of patients with rheumatoid arthritis. Adv Rheumatol. 2021;61:57. [DOI] [PubMed]

24.

Zhang L, Cai P, Zhu W. Depression has an impact on disease activity and health-related quality of life in rheumatoid arthritis: a systematic review and meta-analysis. Int J Rheum Dis. 2020;23:285–93. [DOI] [PubMed]

25.

Moriarty O, McGuire BE, Finn DP. The effect of pain on cognitive function: a review of clinical and preclinical research. Prog Neurobiol. 2011;93:385–404. [DOI] [PubMed]

26.

Gualtieri CT, Morgan DW. The frequency of cognitive impairment in patients with anxiety, depression, and bipolar disorder: an unaccounted source of variance in clinical trials. J Clin Psychiatry. 2008;69:1122–30. [DOI] [PubMed]

27.

Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology (Oxford). 2013;52:2136–48. [DOI] [PubMed] [PMC]

28.

Julian LJ, Yazdany J, Trupin L, Criswell LA, Yelin E, Katz PP. Validity of brief screening tools for cognitive impairment in rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2012;64:448–54. [DOI] [PubMed] [PMC]

29.

Kremer JM, Pappas DA, Kane K, Greenberg J, Harrold LR, Feathers VL, et al. The clinical disease activity index and the routine assessment of patient index data 3 for achievement of treatment strategies. J Rheumatol. 2021;48:1776–83. [DOI] [PubMed]

30.

Prichep LS, John ER, Ferris SH, Rausch L, Fang Z, Cancro R, et al. Prediction of longitudinal cognitive decline in normal elderly with subjective complaints using electrophysiological imaging. Neurobiol Aging. 2006;27:471–81. [DOI] [PubMed]

31.

Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011;7:270–9. [DOI] [PubMed] [PMC]