Prevalence of Cognitive Impairment among Iraqi Patients with Ankylosing Spondylitis

Abstract

Abstract Background: Ankylosing spondylitis (AS) is the prototype of spondyloarthropathies and one of the common rheumatic diseases (RDs). Various degrees of cognitive impairment have been reported with most autoimmune RDs. Objectives: To estimate the prevalence of cognitive impairment in AS patients and its relationship to disease activity and functional limitations and the effect of various sociodemographic and clinical characteristics on cognitive function in AS patients. Materials and Methods: This case–control study comprised 100 patients with AS and 100 healthy subjects who were matched for age, gender, and educational level. Private interviews were conducted with participants to complete the questionnaire and evaluate cognitive function using the 6-item Cognitive Impairment Test (6-CIT) and the Montreal Cognitive Assessment (MoCA). Results: According to MoCA, 48% of AS patients and 16% of healthy controls were cognitively impaired (P = 0.001). By 6-CIT, 6% of the AS group had cognitive impairment, whereas all 100 controls had normal cognitive function (P = 0.029). There was a significant direct correlation between 6-CIT score with marital status (P = 0.020), BMI (P = 0.021), and Bath Ankylosing Spondylitis Disease Activity Index (P = 0.008) and inverse correlation with employment (P = 0.015), education (P = 0.008), and family income (P = 0.12). There was significant direct correlation between MoCA with employment (P = 0.009), education (P = 0.005), family income (P = 0.022), and use of non-steroidal anti-inflammatory drugs (NSAIDs) (P = 0.008) and inverse correlation with marital status (P = 0.002). Conclusions: Patients with AS have a higher degree of cognitive impairment than healthy individuals. It is associated with disease activity, lower socioeconomic status, being widowed, and obesity. Use of NSAIDs is associated with lower cognitive impairment.