Evaluation of Cognitive Functions and Depression among Elderly Patients with Rheumatoid Arthritis

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disorder that primarily affects the joints and frequently presents with extra-articular manifestations including respiratory, cardiovascular, and neurological problems.
Objective: This study aimed to investigate depression prevalence and its contributing factors, as well as the assessment of cognitive functions in elderly RA cases.
Subjects and methods: 134 elderly cases with RA were included, with comprehensive documentation of their sociodemographic profiles and clinical features. Cognitive function was assessed utilizing Mini-Mental State Examination (MMSE), while Geriatric Depression Scale (GDS) was employed to evaluate the presence and severity of depressive symptoms. Rheumatoid factor (RF), C-reactive protein (CRP), anti-citrullinated protein antibody (ACPA), and erythrocyte sedimentation rate (ESR) were performed. Health assessment questionnaire (HAQ) and disease activity score (DAS-28) were assessed.
Results: There were 86 females and 48 males with a mean age of 68.13 ±2.4 years, and disease duration of 11.8 ± 5.2 years. 66.4% of RA cases were classified to have cognitive impairment according to MMSE (69.7% mild, 21.3% moderate, and 9% severe degree), while cases with depression accounted for 77.6% of the total with a mean GDS of 7.5 ± 3.3. Disease duration, DAS-28, and ACPA significantly positively correlated with MMSE and GDS (p = 0.0001).
Conclusion: Cognitive impairment and depression were quite common among elderly RA cases. Disease duration and DAS-28 were the main predictors of occurrence of both conditions.