Prevalence of neurocognitive impairment in patients with rheumatoid arthritis – a systematic review and meta-analysis.

Abstract\nHIGHLIGHTS<bold>Objective</bold>This study aimed to evaluate prevalence rates (PRs) of neurocognitive impairment and its potential moderators among patients with rheumatoid arthritis (RA). <bold>Method</bold>A systematic review of the available literature and data extraction was undertaken on 6 August 2021, with the update by 14 September 2023, by two reviewers independently. Literature was screened for reported rates of prevalence of neurocognitive impairment in RA patients. The meta-analysis was performed using RStudio with the “meta” library. <bold>Results</bold>Twenty-two studies that fulfilled all selection criteria were carefully analyzed. The PR of neurocognitive impairment was 0.49 [0.38–0.61] across all studies included in the review; 0.75 [0.54–0.88] for the MoCA; 0.56 [0.40–0.72] for the MMSE; and 0.26 [0.16–0.38] for comprehensive batteries. The meta-regression results indicated that, depending on the measurement method, the percentage of subjects with positive rheumatoid factor, women ratio, mean age of participants, mean duration of RA, and percentage of domains that had to be impaired to diagnose neurocognitive impairment turned out to be statistically significant moderators. <bold>Conclusions</bold>Neurocognitive impairment is a clinically relevant condition in many RA patients, and its prevalence is alarming high.Rheumatoid arthritis (RA) is a chronic systemic disease that has a significant negative impact on functioning. Difficulties experienced by RA patients described in the literature may involve various organs and systems, including the central nervous system. The results obtained in the review indicate that cognitive impairment may affect, depending on the measurement method, up to approximately 75% of the patients. Due to potential limitations related to cognitive dysfunctions, such as reduced compliance or difficulties in everyday functioning, such a high prevalence of neurocognitive dysfunctions is an argument for screening RA patients and developing appropriate support methods. [ABSTRACT FROM AUTHOR]