Appenzeller S, Bertolo M B, Costallat L T L
Rheumatology Unit, Department of Internal Medicine, State University of Campinas Faculty of Medical Sciences, Campinas, Brazil.
Methods Find Exp Clin Pharmacol. 2004 Jun;26(5):339-43. doi: 10.1358/mf.2004.26.5.831324.
The objective of this study was to determine the frequency of cognitive impairment in patients with rheumatoid arthritis (RA). A cross-sectional study of 40 patients with RA and 40 healthy controls was performed. To assess cognitive impairment, anxiety and depression, the following standardized psychiatric and clinical research methods were used: the Mini-Mental State Examination (MMSE), logic memory tests, short and long memory tests, verbal fluency tests, attention tests, the Brief Psychiatric Rating Scale (BPRS), the Hospital Anxiety and Depression (HAD)/CAGE scale and the Beck Depression Inventory (BDI). Patients and controls with incomplete primary education were excluded from the study. Statistics were performed by chi-square test and by Fisher's exact test. Cognitive impairment was observed in 30% of patients with RA and in 7.5% (p < 0.05) of healthy controls. Patients with RA had a significantly worse outcome in verbal fluency (p < 0.05), logic memory (p < 0.05) and short memory (p < 0.05). No statistical difference was observed among the results obtained in the MMSE, BPRS, HAD/CAGE and BDI. There was no significant relation to the duration of the illness, use of corticotherapy or disability. We observed a high prevalence of cognitive impairment in RA patients. Cognitive impairment was not related to clinical and treatment features or disability. More studies are necessary to determine clinical impact of cognitive impairment in RA.
本研究的目的是确定类风湿关节炎(RA)患者认知障碍的发生率。对40例RA患者和40例健康对照进行了横断面研究。为评估认知障碍、焦虑和抑郁,采用了以下标准化的精神科和临床研究方法:简易精神状态检查表(MMSE)、逻辑记忆测试、短期和长期记忆测试、语言流畅性测试、注意力测试、简明精神病评定量表(BPRS)、医院焦虑抑郁量表(HAD)/CAGE量表以及贝克抑郁量表(BDI)。小学教育未完成的患者和对照被排除在研究之外。采用卡方检验和费舍尔精确检验进行统计学分析。在30%的RA患者中观察到认知障碍,而在健康对照中这一比例为7.5%(p<0.05)。RA患者在语言流畅性(p<0.05)、逻辑记忆(p<0.05)和短期记忆(p<0.05)方面的结果明显更差。在MMSE、BPRS、HAD/CAGE和BDI的结果中未观察到统计学差异。认知障碍与病程、皮质激素治疗的使用或残疾状况无显著相关性。我们观察到RA患者中认知障碍的患病率较高。认知障碍与临床和治疗特征或残疾状况无关。需要更多研究来确定认知障碍对RA的临床影响。