Background/Purpose: Over the past decade our understanding of the prevalence, and indeed impact of cognitive impairment in rheumatic diseases has increased. Intact cognitive function is imperative not only for quality of life and maintenance of one’s functional capacity, but also for the successful therapeutic management of disease, namely the adherence to treatment regimens. The prevalence of cognitive impairment in community dwelling older adults has been estimated at 13%.¹To date the prevalence of cognitive impairment in Polymyalgia Rheumatica (PMR) has not been studied. The aim of this research is therefore to explore the prevalence and potential associated factors of cognitive impairment in those with PMR.

Methods: Patients with a diagnosis of PMR (fulfilling the 2012 EULAR/ACR Classification Criteria) who were in clinical remission and on active treatment with glucocorticoids were recruited from two centres. Patients were ≥3 months and ≤12 months from diagnosis. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) test which was conducted by two trained interviewers. Cognitive impairment was defined by the previously validated MoCA cut-off score of < 26.Demographics, clinical and laboratory data, in addition to patient reported outcomes (PRO's) were collected. PRO's including anxiety, using the Generalised Anxiety Disorder Assessment (GAD-7), mood using the Patient Health Questionnaire (PHQ-9), fatigue using the Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), pain using the visual analogue scale (VAS) and overall health related quality of life using the Health Assessment Questionnaire-Disability Index (HAQ-DI).The associations between categorical variables were compared using the chi-squared or Fishers exact test as appropriate. The association between continuous variables and categorical variables were assessed using the Kruskal-Wallis test. Correlations were calculated using Pearson's r. All analyses were conducted using R (R Core Team, 2022). A p-value of < 0.05 was considered as statistically significant.

Results: 51 consecutive patients with PMR were recruited, of which 56.9% (n=29) were female. 70.6% (n=36) of patients were cognitively impaired, with visual-spatial, delayed recall and abstraction the most commonly affected cognitive domains. Interestingly, those with cognitive impairment had a younger age, versus those without (p=0.514). Although not statistically significant, median BMI, anxiety, depression and pain scores were all higher in those who were cognitively impaired. Moreover, median fatigue scores were also worse in the cognitively impaired group. No statistically significant difference in serum markers was observed.

Conclusion: This study demonstrates the burden of cognitive impairment in PMR is significant and is markedly higher than that observed usually at population level. This has a potential profound impact on disease management, including treatment compliance, and thus disease outcomes. Future studies exploring this, in addition to specific etiologic contributors of cognitive impairment are needed.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/cognitive-function-and-its-associated-factors-in-polymyalgia-rheumatica/