Baker Nancy A, Barbour Kamil E, Helmick Charles G, Zack Matthew, Al Snih Soham
Arthritis Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
University of Pittsburgh, 5012 Forbes Tower, Pittsburgh, PA, 15260, USA.
Rheumatol Int. 2017 Jun;37(6):955-961. doi: 10.1007/s00296-017-3698-1. Epub 2017 Mar 23.
Adults aged 65 or older with arthritis may be at increased risk for cognitive impairment [cognitive impairment but not dementia (CIND) or dementia]. Studies have found associations between arthritis and cognition impairments; however, none have examined whether persons with arthritis develop cognitive impairments at higher rates than those without arthritis. Using data from the Health and Retirement Study, we estimated the prevalence of cognitive impairments in older adults with and without arthritis, and examined associations between arthritis status and cognitive impairments. We calculated incidence density ratios (IDRs) using generalized estimating equations to estimate associations between arthritis and cognitive impairments adjusting for age, sex, race/ethnicity, marital status, education, income, depression, obesity, smoking, the number of chronic conditions, physical activity, and birth cohort. The prevalence of CIND and dementia did not significantly differ between those with and without arthritis (CIND: 20.8%, 95% CI 19.7-21.9 vs. 18.3%, 95% CI 16.8-19.8; dementia: 5.2% 95% CI 4.6-5.8 vs. 5.1% 95% CI 4.3-5.9). After covariate control, older adults with arthritis did not differ significantly from those without arthritis for either cognitive outcome (CIND IDR: 1.6, 95% CI = 0.9-2.9; dementia IDR: 1.1, 95% CI = 0.4-3.3) and developed cognitive impairments at a similar rate to those without arthritis. Older adults with arthritis were not significantly more at risk to develop cognitive impairments and developed cognitive impairments at a similar rate as older adults without arthritis over 6 years.
65岁及以上患有关节炎的成年人可能患认知障碍（认知障碍但非痴呆症[CIND]或痴呆症）的风险更高。研究发现关节炎与认知障碍之间存在关联；然而，尚无研究考察患有关节炎的人发生认知障碍的几率是否高于未患关节炎的人。利用健康与退休研究的数据，我们估计了患有关节炎和未患关节炎的老年人中认知障碍的患病率，并考察了关节炎状况与认知障碍之间的关联。我们使用广义估计方程计算发病率密度比（IDR），以估计在调整年龄、性别、种族/族裔、婚姻状况、教育程度、收入、抑郁、肥胖、吸烟、慢性病数量、身体活动和出生队列后关节炎与认知障碍之间的关联。患有关节炎和未患关节炎的人之间，CIND和痴呆症的患病率没有显著差异（CIND：20.8%，95%CI 19.7 - 21.9 vs. 18.3%，95%CI 16.8 - 19.8；痴呆症：5.2%，95%CI 4.6 - 5.8 vs. 5.1%，95%CI 4.3 - 5.9）。在控制协变量后，患有关节炎的老年人在两种认知结果上与未患关节炎的老年人没有显著差异（CIND IDR：1.6，95%CI = 0.9 - 2.9；痴呆症IDR：1.1，95%CI = 0.4 - 3.3），并且发生认知障碍的几率与未患关节炎的人相似。患有关节炎的老年人发生认知障碍的风险并没有显著更高，并且在6年时间里发生认知障碍的几率与未患关节炎的老年人相似。
