ROMATOİD ARTRİTTE BİLİŞSEL BOZUKLUĞUN DEĞERLENDİRİLMESİ: EKLEM YIKIMI VE HASTALIK AKTİVİTESİNİN BELİRLEYİCİ DEĞERİ

Year 2018, , 86 - 92, 23.07.2018

Derya Güzel , Sinem Sağ Mustafa Serdar Sağ , İbrahim Tekeoğlu Ayhan Kamanlı , Kemal Nas

https://doi.org/10.18229/kocatepetip.446832

Cited By: 1

Abstract

AMAÇ: Romatoid Artrit (RA), oryantasyon, dikkat ve
bellek zayıflığı gibi azalmış bilişsel işlevlere neden olur.
Sunulan bu çalışmanın amacı RA’da bilişsel işlevlerin bir
belirleyicisi olarak eklem yıkımını ve hastalığın diğer parametrelerini
değerlendirmektir.

GEREÇ VE YÖNTEM: Bu kesitsel çalışma, 45 hasta ve 40
sağlıklı kontrol içemektedir. RA’lı hastalarda radyolojik
progresyon skoru (≥0.5, modifiye Sharp / van der Heijde
skorları- MTS’ler), 28 eklemin hastalık aktivite skoru
(DAS-28) ve 44 eklemin hastalık aktivite skoru (DAS-44)
değerlendirildi. Mini Mental Test (MMSE) ve Hastane
Anksiyete Depresyon Ölçeği (HADÖ) değerlendirildi.
Sonuçlar, bilişsel işlevleri belirlemek için hasta ve kontrol
grubu arasında karşılaştırıldı.

BULGULAR: MMSE skorları açısından gruplar arasında
istatistiksel olarak anlamlı fark vardı (p=0.003). RA
ve kontrol grupları arasında anksiyete ve depresyon
düzeyleri açısından anlamlı farklılık yoktu. MMSE
skoru; hastalık süresi (p=0.011, r=-0.371), Sharp skoru
(p=0.018, r=-0.350) ve DAS-28(p=0.044, r=-0.296) skoru
ile ilişkilendirildi. Depresyon skoru da DAS ile ilişkiliydi
(p=0.004, r=0.425). Romatoid faktör düzeyleri, antisiklik
sitrullinat peptid düzeyleri ve bilişsel işlev testleri
arasında herhangi bir ilişki bulunamadı.

SONUÇ: Sonuçlar, uzun süredir RA olan hastalarda
inflamatuar mediatörlere maruz kalmanın, eklemleri
etkilediği sürece merkezi sinir sisteminde de bozulmaya
neden olabileceğini göstermektedir. Bilişsel bozulma,
hastalık şiddeti ve eklem yıkımı ile ilişkili idi. Dolayısıyla,
radyografik eklem hasarı, RA’daki bu kronik süreç boyunca
nöronal hasarın ve bilişsel bozulmanın boyutunu yansıtan
pozitif bir ön belirteç olabilir.

Keywords

Romatoid artrit, Sharp skoru, Bilişsel bozulma

EVALUATION OF COGNITIVE IMPAIRMENT IN RHEUMATOID ARTHRITIS: PREDICTIVE VALUE OF JOINT DESTRUCTION AND DISEASE ACTIVITY

Abstract

OBJECTIVE: Rheumatoid Arthritis (RA) cause poor
cognitive functions including reduced memory,
orientation and attention. The aim of the present study
is to evaluate joint destruction and other parameters of
disease as a predictor of cognitive functions in RA.

MATERIAL AND METHODS: This cross-sectional study
included forty five patients and forty healthy controls.
Radiological progression score (≥0.5 the modified Sharp/
van der Heijde scores- MTSs), disease activity score
of 28 joints (DAS-28) and disease activity score of 44
joints (DAS-44) were evaluated in patients with RA. Mini
Mental State Examination (MMSE) and Hospital Anxiety
Depression Scale (HADS) were evaluated and the results
were compared between patients and control groups to
determinate cognitive functions.

RESULTS: There was a statistically significant difference
between groups in terms of MMSE scores (p=0.003). There
were no significant differences in terms of anxiety and
depression levels between RA and control groups. MMSE
score was correlated with disease duration (p=0.011, r=-
0.371), Sharp score (p=0.018, r=-0.350) and DAS-28 score
(p=0.044, r=-0.296). Depression score was also correlated
with DAS (p=0.004, r=0.425). No relationship was found
between Rheumatoid factor levels, anti-cyclic citrullinated
peptide levels and the cognitive function tests.

CONCLUSIONS: The results indicate that exposure
to inflammatory mediators in patients with long
standing RA may lead to deterioration on central
nervous system as long as affecting joints. Cognitive
deterioration was correlated with disease severity
and joint destruction. Thus, the radiographic joint
destruction can be a positive predictor of reflecting
the extent of neuronal damage and cognitive
deterioration during this chronic process in RA.

Keywords

Rheumatoid arthritis; Sharp score; Cognitive decline

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