The relationship between cognitive function and physical function in rheumatoid arthritis

To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA). Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive functi...

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Published in:	Journal of rheumatology Vol. 40; no. 3; p. 236
Main Authors:	Shin, So Young, Julian, Laura, Katz, Patricia
Format:	Journal Article
Language:	English
Published:	Canada 01.03.2013
Subjects:	Activities of Daily Living Adult Aged Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - physiopathology Arthritis, Rheumatoid - psychology Cognition Cognition Disorders - complications Cognition Disorders - physiopathology Cognition Disorders - psychology Cohort Studies Disability Evaluation Disabled Persons Female Health Status Humans Interviews as Topic Male Middle Aged Motor Activity - physiology Neuropsychological Tests
ISSN:	0315-162X, 1499-2752, 1499-2752
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Abstract	To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA). Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as "impaired" if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as "impaired" (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties. There were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: β = -0.24, p = 0.014; HAQ: β = 0.24, p = 0.003) but not with disability (VLA: β = 0.10, p = 0.207). Cognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA.
AbstractList	To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA). Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as "impaired" if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as "impaired" (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties. There were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: β = -0.24, p = 0.014; HAQ: β = 0.24, p = 0.003) but not with disability (VLA: β = 0.10, p = 0.207). Cognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA. To examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA).OBJECTIVETo examine the relationship between cognitive impairment and functional limitations and disability in persons with rheumatoid arthritis (RA).Individuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as "impaired" if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as "impaired" (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties.METHODSIndividuals from a longitudinal cohort study of RA participated in study visits that included physical, psychosocial, and biological metrics. Cognitive function was assessed using a battery of 12 standardized neuropsychological measures yielding 16 indices covering a range of cognitive domains. On each test, subjects were classified as "impaired" if they performed 1 SD below age-based population norms. Total cognitive function scores were calculated by summing the number of tests on which individuals were classified as "impaired" (higher scores = greater impairment). Performance-based and self-reported functional limitations were assessed with the Short Physical Performance Battery (SPPB) and the Health Assessment Questionnaire (HAQ), respectively. Self-reported disability was measured with the Valued Life Activities (VLA) scale. Multiple regression analyses controlling for sex, race, education, cardiovascular comorbidity, disease duration, disease severity, and depression were conducted to identify whether cognitive impairment was independently associated with physical function difficulties.There were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: β = -0.24, p = 0.014; HAQ: β = 0.24, p = 0.003) but not with disability (VLA: β = 0.10, p = 0.207).RESULTSThere were 122 subjects with mean (SD) age of 58.4 (± 10.8) years; 62% were female and 80% were white. In multivariate regression models, total cognitive function score was significantly associated with greater functional limitations (SPPB: β = -0.24, p = 0.014; HAQ: β = 0.24, p = 0.003) but not with disability (VLA: β = 0.10, p = 0.207).Cognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA.CONCLUSIONCognitive impairment was significantly associated with greater functional limitations in patients with RA, suggesting that cognitive impairment may play a role in poor functional status in persons with RA.
Author	Katz, Patricia Julian, Laura Shin, So Young
Author_xml	– sequence: 1 givenname: So Young surname: Shin fullname: Shin, So Young email: fantasy45@gmail.com organization: College of Nursing, Keimyung University, Daegu, South Korea. fantasy45@gmail.com – sequence: 2 givenname: Laura surname: Julian fullname: Julian, Laura – sequence: 3 givenname: Patricia surname: Katz fullname: Katz, Patricia
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SubjectTerms	Activities of Daily Living Adult Aged Arthritis, Rheumatoid - complications Arthritis, Rheumatoid - physiopathology Arthritis, Rheumatoid - psychology Cognition Cognition Disorders - complications Cognition Disorders - physiopathology Cognition Disorders - psychology Cohort Studies Disability Evaluation Disabled Persons Female Health Status Humans Interviews as Topic Male Middle Aged Motor Activity - physiology Neuropsychological Tests
Title	The relationship between cognitive function and physical function in rheumatoid arthritis
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