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类风湿关节炎和系统性硬化症患者的认知功能障碍和抑郁症状:一项临床研究。

Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study.

机构信息

Mental Health Services, Department of Medicine, School of Health Sciences, Patras University Hospital, University of Patras, Rion 26504, Patras, Greece.

Global Brain Health Institute, School of Medicine, Trinity College Dublin, University of Dublin, Dublin, Republic of Ireland.

出版信息

BMC Psychiatry. 2023 Jul 18;23(1):513. doi: 10.1186/s12888-023-04995-3.

Abstract

BACKGROUND

Recently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer's disease (MiND) and to individuals without cognitive impairment.

METHODS

Cognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models.

RESULTS

The study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups.

CONCLUSIONS

Patients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.

摘要

背景

最近,风湿性疾病中出现的认知缺陷引起了科学界的关注。类风湿关节炎(RA)和系统性硬化症(SSc)患者的认知症状尚未得到彻底研究。本研究旨在评估 RA 和 SSc 患者的认知功能及其与抑郁症状的关系,并将其与阿尔茨海默病相关的轻度认知障碍(MiND)和无认知障碍的个体进行比较。

方法

使用认知电话筛查工具加(COGTEL+)、串行七项测试(SST)、简易精神状态检查(MMSE)和老年抑郁量表-15(GDS)分别评估认知功能和抑郁症状。统计分析包括组间分析、相关性分析和回归分析。回归模型中考虑了人口统计学特征。

结果

该研究纳入了 30 名 RA 患者、24 名 SSc 患者、26 名无认知障碍的成年人和 33 名 MiND 患者。与无认知障碍的个体相比,RA 患者在言语短期记忆、注意力/集中、言语流畅性和 MMSE 方面的表现较差。值得注意的是,RA 患者在言语流畅性、注意力/集中、归纳推理和 MMSE 方面的表现均劣于 MiND。SSc 患者在言语流畅性和 MMSE 方面的表现均劣于无认知缺陷的成年人。SSc 患者的言语流畅性缺陷超过了 MiND。MMSE、COGTEL+、前瞻性记忆、工作记忆、言语流畅性和注意力/集中与 GDS 评分相关,且各组间无差异。

结论

RA 和 SSc 患者存在认知功能障碍,部分与抑郁症状有关。值得注意的是,在许多情况下,认知功能障碍的严重程度超过了 MiND。

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