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Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis

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Abstract

This study explored the discrepancy between perceived cognitive dysfunction and computerized neuropsychological test performance in Korean patients with RA. Individuals with RA were recruited by their rheumatologists during follow-up visits at one hospital in Korea. After getting signed consents, a trained research nurse assessed participants with a range of physical, psychosocial, and biological metrics. Subjective cognitive dysfunction was assessed using the Perceived Deficits Questionnaire (PDQ; range 0–20). Objective cognitive impairment was assessed using a set of 6 computerized neurocognitive tests yielding 12 indices covering a range of cognitive domains. Subjects were classified as ‘impaired’ if they performed 1 SD below age-based population norms on each test. A total cognitive function score was calculated by summing the transformed scores (range 0–12). Multiple linear regression analyses determined the relationship of total cognitive function score with PDQ score, controlling for disease activity, functional limitations, and psychological factors. Forty subjects (mean ± SD age: 63.1 ± 11.4 years) were included. Mean ± SD scores of total cognitive function and PDQ were 7.3 ± 2.7 (2–12) and 11.8 ± 5.1 (5–25), respectively. In multivariate analysis, there was no significant relationship between total cognitive function score and PDQ score. However, depression and sleep quality (β = 0.37, p = 0.025; β = 0.17, p = 0.034) were significantly associated with PDQ score. The findings emphasize the gap between subjective and objective measures of cognitive impairment and the importance of considering psychological factors within the context of cognitive complaints in clinical settings.

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Authors and Affiliations

  1. Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea

    Bo Young Yoon & Joo-Hyun Lee

  2. Department of Nursing, College of Medicine, Inje University, Bokji-ro 75, Busanjin-gu, Busan, 47392, Korea

    So Young Shin

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  1. Bo Young Yoon
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  2. Joo-Hyun Lee
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  3. So Young Shin
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Correspondence to So Young Shin.

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Informed consent was obtained from all participants included in the study.

Funding source

This study was supported by the 2015 Inje University Research Grant (No. 20151092).

Conflict of interest

No conflict of interest has been reported by the authors.

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Yoon, B., Lee, JH. & Shin, S.Y. Discrepancy between subjective and objective measures of cognitive impairment in patients with rheumatoid arthritis. Rheumatol Int 37, 1635–1641 (2017). https://doi.org/10.1007/s00296-017-3806-2

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  • DOI: https://doi.org/10.1007/s00296-017-3806-2

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