Cognitive Dysfunction in Autoimmune Rheumatic Diseases

Csaba Oláh; Noa Schwartz; Christopher Denton; Zsófia Kardos; ChaimPutterman; Zoltán Szekanecz


Arthritis Res Ther. 2020;22(78) 

In This Article

Abstract and Introduction


For people with chronic autoimmune rheumatic diseases (AIRD), such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or systemic sclerosis (SSc), normal cognitive functions are essential for performing daily activities. These diseases may be associated with cognitive dysfunction (CD). In RA, CD has been associated with age, lower education and disease duration and activity. Great advances have been achieved in neuropsychiatric SLE in the identification of pathogenic pathways, assessment and possible treatment strategies. SSc rarely exerts direct effects on the brain and cognitive function. However, the psychological burden that includes depression, anxiety and social impact may be high. AIRD patients with sustained disease activity, organ damage or lower education should be evaluated for CD. The control of systemic inflammation together with tailored behavioural cognitive therapies may benefit these patients.


Cognitive function includes orientation, attention/concentration, judgment/problem solving and memory, verbal, visual/spatial and executive functions.[1] Several standardised measures of cognitive function have been developed. These include the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), Victoria Stroop Test (VST), Wechsler Adult Intelligence Scale (WAIS) and Benton Visual Retention Test (BVRT). Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAIT/S) may be used to assess depression and anxiety, respectively.[2] For people with chronic illnesses, such as autoimmune-inflammatory rheumatic diseases (AIRD), intact cognitive functioning is crucial for performing many key daily tasks, including medical treatment adherence or planning activities. Most AIRDs have been associated with various degrees of cognitive dysfunction (CD) (reviewed in[1,3,4]). In this review, we will briefly discuss CD in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).