Exercise Helps Cognitive Function in RA Patients

A recent study analyzed the effects of lifestyle factors on cognitive function in patients with rheumatoid arthritis (RA). The researchers concluded that RA patients who take part in regular physical activity are less likely to report a decline in cognitive function.

“Potentially modifiable lifestyle factors such as inactivity and obesity are risk factors for cognitive decline in the general population,” reported the researchers, whose findings appeared in ACR Open Rheumatology. “However, little is known about how these factors may contribute in the setting of a chronic inflammatory condition such as RA, although one study in systemic lupus erythematosus reported similar risk. In the present analysis, we studied RA patients followed since 2003 who reported yearly on their perceived cognition to better understand the risk factors for this outcome.”

RA patients completed a clinical and functional questionnaire spanning 10 years that included data on self-reported memory, concentration, and word-finding difficulties, which was graded from “never” to “often.” Exercise was defined per the Department of Health and Human Services physical activity guidelines, which calls for 75 minutes of vigorous or 150 minutes of moderate aerobic activity per week. In addition to exercise, researchers also analyzed the role of body mass index (BMI), sleep, depression (Mental Health Index-Depression, Disease Activity Score (DAS)28–c-reactive protein (CRP)3 score, disease-modifying antirheumatic drugs (DMARDs), and corticosteroid use. These factors were compared to responses from the year prior as predictors of cognitive complaints that progressed to “often” from one year to the next.

Of 1,219 RA patients, 127 (10.4%) self-reported poor memory, poor concentration, or word-finding difficulties graded as “often” at the start of the study. RA patients (n = 1092, mean age = 56.5 years, 82% female, 58% college educated) who were physically active were less likely to report word-finding difficulties (P=0.0001), poor memory (P=0.01), and poor concentration (P<0.0001). Female patients were more likely than males to complain of concentration difficulties (P=0.03), and patients who were taking an anti-tumor necrosis factor therapy had lower rates of poor memory complaints (P=0.01). No independent association was observed between declining cognitive function and sleep, BMI, fatigue, depression, DAS28-CRP3, methotrexate, and corticosteroid use.

The researchers concluded, “RA patients who are physically active are less likely to report cognitive difficulties. Our study suggests potential modifiable risk factors for the prevention of cognitive dysfunction in RA.”