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Abstract

People living with rheumatoid arthritis (RA) commonly experience pain, fatigue, and poor sleep, all of which could affect cognitive function. A systematic review with narrative synthesis was performed to investigate whether cognitive function differs in individuals with RA compared to the general population, and if so, which domains of cognitive function are affected. The literature search yielded 758 titles, with 11 articles meeting inclusion criteria. Of these, 9 reported significant differences in cognitive function between the RA group and controls in at least one cognitive domain, including fluency, attention, memory, and simple reaction time. No differences were found in reasoning, comprehension, and intellectual ability across all studies. Further research is necessary to explore these differences and understand their underlying causes. In addition to the systematic review, a cross-sectional study aimed to identify factors associated with cognitive impairment (CI) in RA was conducted using data from a 2018 survey of an RA cohort. Participants (n=146, mean age: 73.7, mean RA duration: 31.2 years) completed a self-report questionnaire including data on sociodemographic characteristics, RA-specific information, comorbidities, and health behaviors. The Everyday Memory Questionnaire (EMQ) assessed the memory domain of cognitive function. Descriptive statistics characterized the sample, and multivariable linear regression analyses identified variables associated with cognitive function. The mean global EMQ score was 21.8, with 20% classified as having CI. Memory impairment was associated with depression, disease activity (measured by RADAI), fatigue, sleep disturbances, and comorbidities such as fibromyalgia, and kidney disease. This combined research highlights the prevalence and importance of cognitive impairment in individuals with RA. The systematic review emphasizes the need for further studies to understand cognitive differences, while the cross-sectional study identifies potentially modifiable factors associated with memory impairment. Future research should evaluate the causal relationships of these factors and develop targeted interventions to improve cognitive function and overall management of cognitive impairment in RA patients.