Session Title: Rehabilitation Sciences
Session Type: Abstract Submissions (ARHP)
Background/Purpose: There is an increased appreciation of the burden of cognitive impairment in persons with rheumatoid arthritis (RA). Research shows a gap between perceived cognitive dysfunction and objective neuropsychological performance in persons with chronic diseases. This study explored this relationship in persons with RA.
Methods: Individuals from a longitudinal cohort study of RA participated in a study visit that included physical, psychosocial, and biological metrics. Subjective cognitive dysfunction was assessed using the Perceived Deficits Questionnaire (PDQ; range 0-20, higher score=greater impairment). Objective cognitive impairment was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices. On each test, subjects were classified as ‘impaired’ if they performed 1 SD below age-based population norms. A total cognitive impairment score (range 0-16) was calculated by summing the transformed scores (higher score=worst impairment). Multiple regression analyses controlling for gender, race, marital status, income, education, disease duration, disease severity, depression, and fatigue were conducted to identify the relationship between objective and subjective cognitive measures.
Results: 120 subjects with mean (±SD) age of 58.5 (±11.0) years were included. Sixty four percent were female, 82% were white, and 7% met criteria for major depressive disorder. Mean educational level was 15.3 (±2.2) years and disease duration was 19.9 (±11.1) years. Mean total cognitive impairment score was 2.5 (±2.2, range 0-10). The proportion of persons classified as cognitively impaired on each test ranged from 8% (semantic fluency test) to 28% (design fluency test). Mean PDQ score was 5.8 (±3.8, range 0-16). In the multivariate analysis, there was no significant relationship between PDQ score and total cognitive impairment score. However, depression and fatigue (ß=0.31, p<0.001; ß=0.32, p=0.001) were significantly associated with the PDQ score.
Conclusion: There was no significant relationship between perceived cognitive dysfunction and objective neuropsychological performance in this cohort. Depression and fatigue were significantly associated with perceived cognitive dysfunction. Findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors in the context of cognitive complaints in clinical settings.
S. Y. Shin,
P. P. Katz,
L. J. Julian,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-relationship-between-perceived-cognitive-dysfunction-and-objective-neuropsychological-performance-in-persons-with-rheumatoid-arthritis/