Dano cognitivo em artrite reumatoide
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Tipo
TCC
Data de publicação
2024-06-13
Periódico
Citações (Scopus)
Autores
Souza, Ricardo Castilho de
Reimann, Rodrigo Mori
Reimann, Rodrigo Mori
Orientador
Skare, Thelma Larocca
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Introdução: Artrite reumatoide (AR) é uma doença autoimune sistêmica
poliarticular, aditiva e bilateral. Afeta 1% da população mundial, principalmente
mulheres. Manifestações extra-articulares podem ser encontradas, e entre elas
a alteração do comprometimento cognitivo. O impacto do processo inflamatório
tal qual o do tratamento da AR nesta situação estão pouco elucidados,
Objetivos: Analisar a presença de disfunções cognitivas em pacientes com AR
verificando possível influência do grau de atividade da doença assim como a
possível associação das disfunções cognitivas com a qualidade de vida física e
mental destes pacientes. Métodos: Estudo transversal observacional
envolvendo 138 mulheres, sendo 92 pacientes com AR em acompanhamento
ambulatorial em reumatologia no Hospital Universitário Evangélico Mackenzie e
46 controles. Foram realizadas coletas de dados em prontuários e aplicação de
questionários que avaliaram o desempenho cognitivo (MoCA), e qualidade de
vida física e mental (SF-12). Resultados: Observaram-se diferenças no
resultado do MoCA (média de 16.8 em AR vs 18.9 em controles com p=0.02).
Dentre as habilidades avaliadas com a aplicação do MoCA, os domínios
visuoespacial, abstração e evocação tardia foram os mais afetados entre os
pacientes. Já os resultados do questionário SF-12 mostraram pior qualidade de
vida física entre os pacientes (P<0.0001), sem alteração na qualidade de vida
mental (P=0.09). Dados de atividade da doença não se correlacionaram
diretamente a cognição. Fatores como o aumento da idade (p<0,0001), menor
tempo de estudo formal (p<0,0001) e maior tempo de diagnóstico da doença
(P=0,01) se correlacionaram com menores pontuações no teste cognitivo.
Alterações de cognição afetaram a qualidade de vida física (p =0,04) mas não
mental (p=0.72). Conclusão: Existe alta incidência de distúrbios cognitivos em
pacientes com AR quando comparado a controles saudáveis. O grau de
atividade da doença não está diretamente associado a distúrbio da cognição.
Existe forte associação entre as disfunções cognitivas e o declínio da qualidade
de vida física. Não foi comprovada associação direta de distúrbio cognitivo na
AR com a qualidade de vida mental nos pacientes estudados.
Introduction: Rheumatoid Arthritis (RA) is a polyarticular, additive and bilateral systemic autoimmune disease. It affects 1% of the world's population, mainly women. Extra-articular manifestations can be found, including changes in cognitive impairment. The impact of the inflammatory process as well as that of RA treatment in this situation is poorly understood. Objectives: To analyze the presence of cognitive dysfunctions in patients with Rheumatoid Arthritis, verifying the possible influence of the disease activity and the association of cognitive dysfunctions with the physical and mental quality of life of these patients. Methods: Observational cross-sectional study involving 138 females, with 92 RA patients undergoing outpatient rheumatology follow-up at the Hospital Universitario Evangélico Mackenzie, and 46 controls. Data were collected from medical records and questionnaires were administered to assess cognitive performance (MoCA) and quality of physical and mental life (SF-12). Results: MoCA results were lower in RA than in controls (mean of 16.8 in RA vs mean of 18.9 in controls; p=0.02). Among the skills assessed with the application of MoCA, the visuospatial, abstraction and delayed recall domains were the most affected among patients. The results of the SF-12 questionnaire showed worse physical quality of life among patients (P<0.0001), associate with cognition. Factors such as increasing age (p<0.0001), less time in formal study (p<0.0001) and longer time since diagnosis of the disease (p=0.01) correlated with lower scores on the cognitive test. Cognitive alterations affected physical (p=0.04) but not mental (p=0.72) quality of life. Conclusion: There is a high incidence of cognitive disorders in RA patients when compared to healthy controls. The degree of disease activity is not directly related to the cognition disorder. There is a strong association between cognitive dysfunctions and a decline in physical quality of life. There was no direct association between cognitive disorders in RA and mental quality of life in the patients studied.
Introduction: Rheumatoid Arthritis (RA) is a polyarticular, additive and bilateral systemic autoimmune disease. It affects 1% of the world's population, mainly women. Extra-articular manifestations can be found, including changes in cognitive impairment. The impact of the inflammatory process as well as that of RA treatment in this situation is poorly understood. Objectives: To analyze the presence of cognitive dysfunctions in patients with Rheumatoid Arthritis, verifying the possible influence of the disease activity and the association of cognitive dysfunctions with the physical and mental quality of life of these patients. Methods: Observational cross-sectional study involving 138 females, with 92 RA patients undergoing outpatient rheumatology follow-up at the Hospital Universitario Evangélico Mackenzie, and 46 controls. Data were collected from medical records and questionnaires were administered to assess cognitive performance (MoCA) and quality of physical and mental life (SF-12). Results: MoCA results were lower in RA than in controls (mean of 16.8 in RA vs mean of 18.9 in controls; p=0.02). Among the skills assessed with the application of MoCA, the visuospatial, abstraction and delayed recall domains were the most affected among patients. The results of the SF-12 questionnaire showed worse physical quality of life among patients (P<0.0001), associate with cognition. Factors such as increasing age (p<0.0001), less time in formal study (p<0.0001) and longer time since diagnosis of the disease (p=0.01) correlated with lower scores on the cognitive test. Cognitive alterations affected physical (p=0.04) but not mental (p=0.72) quality of life. Conclusion: There is a high incidence of cognitive disorders in RA patients when compared to healthy controls. The degree of disease activity is not directly related to the cognition disorder. There is a strong association between cognitive dysfunctions and a decline in physical quality of life. There was no direct association between cognitive disorders in RA and mental quality of life in the patients studied.
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Palavras-chave
artrite reumatoide , disfunção cognitiva , qualidade de vida , rheumatoid arthritis , cognitive dysfunctions , quality of life