We assessed cognitive function of female rheumatoid arthritis (RA) patients and analyze the determinants, with special focus on cerebrovascular morphology. Sixty methotrexate (MTX-) or biologic-treated RA patients and 39 healthy controls were included in a cross-sectional study. Smoking habits, alcohol intake and time spent in education were recorded. Standard measures were performed to assess cognitive function (Montreal Cognitive Assessment, MOCA; Trail Making Test, TMT; Victoria Stroop Test, VST; Wechsler Adult Intelligence Scale, WAIS; Benton Visual Retention test, BVRT), depression (Beck Depression Inventory, BDI), anxiety (State-Trait Anxiety Inventory, STAIT/S) and general health status (Short Form 36, SF-36). Mean disease activity (28-joint Disease Activity Score, mDAS28; erythrocyte sedimentation rate, mESR; C-reactive protein, mCRP) of the past 12 months was calculated; anti-cyclic citrullinated peptide (CCP) and rheumatoid factor (RF) were assessed. Cerebral vascular lesions and atrophy, carotid intima-media thickness (cIMT) and plaques, as well as median cerebral artery (MCA) circulatory reserve capacity (CRC) were assessed by brain magnetic resonance imaging (MRI), carotid ultrasound and transcranial Doppler, respectively. Cognitive function tests showed impairment in RA vs controls. Biologic- vs MTX-treated subgroups differed in TMT-A. Correlations were identified between cognitive function and depression/anxiety tests. WAIS, STAIS, STAIT and BDI correlated with most SF-36 domains. Numerous cognitive tests correlated with age and lower education. Some also correlated with disease duration, mESR and mDAS28. Regarding vascular pathophysiology, cerebral vascular lesions were associated with VST-A, carotid plaques with multiple cognitive parameters, while MCA and CRC with MOCA, BVRT and BDI. RA patients have significant cognitive impairment. Cognitive dysfunction may occur together with or independently of depression/anxiety. Older patients and those with lower education are at higher risk to develop cognitive impairment. Cognitive screening might be a useful tool to identify subgroups to be further investigated for cerebrovascular pathologies.

中文翻译：

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女性类风湿关节炎患者认知功能的评估：与脑血管病理，抑郁和焦虑的关联。

我们评估了女性类风湿关节炎（RA）患者的认知功能，并分析了决定因素，尤其侧重于脑血管形态。横断面研究包括60例甲氨蝶呤（MTX-）或经生物治疗的RA患者和39名健康对照。记录吸烟习惯，饮酒量和教育时间。进行标准措施来评估认知功能（蒙特利尔认知评估，MOCA； Trail制作测试，TMT；维多利亚·斯特鲁普测试，VST；韦氏成人智力量表，WAIS；本顿视觉保留测试，BVRT），抑郁症（贝克抑郁量表，BDI） ，焦虑（状态特质焦虑量表，STAIT / S）和一般健康状况（简短表格36，SF-36）。平均疾病活动度（28个关节疾病活动度评分，mDAS28；红细胞沉降率，mESR； C反应蛋白，计算了过去12个月的mCRP）；评估抗环瓜氨酸肽（CCP）和类风湿因子（RF）。分别通过脑磁共振成像（MRI），颈动脉超声和经颅多普勒评估了脑血管病变和萎缩，颈动脉内膜中层厚度（cIMT）和斑块以及脑中动脉（MCA）循环储备能力（CRC）。 。认知功能测试显示RA与对照组相比存在障碍。生物治疗组和MTX治疗组在TMT-A中有所不同。认知功能和抑郁/焦虑测试之间存在相关性。WAIS，STAIS，STAIT和BDI与大多数SF-36域相关。许多认知测试与年龄和低学历相关。有些还与疾病持续时间，mESR和mDAS28相关。关于血管病理生理，脑血管病变与VST-A，具有多个认知参数的颈动脉斑块相关，而MCA和CRC与MOCA，BVRT和BDI相关。RA患者有明显的认知障碍。认知功能障碍可能与抑郁症/焦虑症同时发生或与抑郁症/焦虑症无关。老年患者和文化程度较低的患者发生认知障碍的风险较高。认知筛查可能是一种有用的工具，可用于确定需要进一步研究脑血管病变的亚组。老年患者和文化程度较低的患者发生认知障碍的风险较高。认知筛查可能是一种有用的工具，可用于确定需要进一步研究脑血管病变的亚组。老年患者和文化程度较低的患者发生认知障碍的风险较高。认知筛查可能是一种有用的工具，可用于确定需要进一步研究脑血管病变的亚组。