Maria Vassilaki1, Cynthia S Crowson1, John M Davis Iii2, Stephanie Q Duong1, David T Jones3, Aivi Nguyen4, Michelle M Mielke1,5, Prashanthi Vemuri6, Elena Myasoedova1,2. 1. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA. 2. Division of Rheumatology, Mayo Clinic, Rochester, MN, USA. 3. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 4. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA. 5. Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA. 6. Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Abstract
BACKGROUND: Observational studies suggested that dementia risk in patients with rheumatoid arthritis (RA) is higher than in the general population. OBJECTIVE: To examine the associations of RA with cognitive decline and dementia, and neuroimaging biomarkers of aging, Alzheimer's disease, and vascular pathology in adult participants in the Mayo Clinic Study of Aging (MCSA). METHODS: Participants with RA were matched 1:3 on age, sex, education, and baseline cognitive diagnosis to participants without RA. RA cases with MRI were also matched with non-cases with available MRI. All available imaging studies (i.e., amyloid and FDG PET, sMRI, and FLAIR) were included. The study included 104 participants with RA and 312 without RA (mean age (standard deviation, SD) 75.0 (10.4) years, 33% male and average follow-up (SD) 4.2 (3.8) years). RESULTS: Groups were similar in cognitive decline and risk of incident dementia. Among participants with neuroimaging, participants with RA (n = 33) and without RA (n = 98) had similar amyloid burden and neurodegeneration measures, including regions sensitive to aging and dementia, but greater mean white matter hyperintensity volume relative to the total intracranial volume (mean (SD)% : 1.12 (0.57)% versus 0.76 (0.69)% of TIV, p = 0.01), and had higher mean (SD) number of cortical infarctions (0.24 (0.44) versus 0.05 (0.33), p = 0.02). CONCLUSION: Although cognitive decline and dementia risk were similar in participants with and without RA, participants with RA had more abnormal cerebrovascular pathology on neuroimaging. Future studies should examine the mechanisms underlying these changes and potential implications for prognostication and prevention of cognitive decline in RA.
BACKGROUND: Observational studies suggested that dementia risk in patients with rheumatoid arthritis (RA) is higher than in the general population. OBJECTIVE: To examine the associations of RA with cognitive decline and dementia, and neuroimaging biomarkers of aging, Alzheimer's disease, and vascular pathology in adult participants in the Mayo Clinic Study of Aging (MCSA). METHODS: Participants with RA were matched 1:3 on age, sex, education, and baseline cognitive diagnosis to participants without RA. RA cases with MRI were also matched with non-cases with available MRI. All available imaging studies (i.e., amyloid and FDG PET, sMRI, and FLAIR) were included. The study included 104 participants with RA and 312 without RA (mean age (standard deviation, SD) 75.0 (10.4) years, 33% male and average follow-up (SD) 4.2 (3.8) years). RESULTS: Groups were similar in cognitive decline and risk of incident dementia. Among participants with neuroimaging, participants with RA (n = 33) and without RA (n = 98) had similar amyloid burden and neurodegeneration measures, including regions sensitive to aging and dementia, but greater mean white matter hyperintensity volume relative to the total intracranial volume (mean (SD)% : 1.12 (0.57)% versus 0.76 (0.69)% of TIV, p = 0.01), and had higher mean (SD) number of cortical infarctions (0.24 (0.44) versus 0.05 (0.33), p = 0.02). CONCLUSION: Although cognitive decline and dementia risk were similar in participants with and without RA, participants with RA had more abnormal cerebrovascular pathology on neuroimaging. Future studies should examine the mechanisms underlying these changes and potential implications for prognostication and prevention of cognitive decline in RA.
Authors: Jonathan Graff-Radford; Jeremiah A Aakre; David S Knopman; Christopher G Schwarz; Kelly D Flemming; Alejandro A Rabinstein; Jeffrey L Gunter; Chadwick P Ward; Samantha M Zuk; A J Spychalla; Gregory M Preboske; Ronald C Petersen; Kejal Kantarci; John Huston; Clifford R Jack; Michelle M Mielke; Prashanthi Vemuri Journal: Mayo Clin Proc Date: 2020-06 Impact factor: 7.616
Authors: Clifford R Jack; Heather J Wiste; Terry M Therneau; Stephen D Weigand; David S Knopman; Michelle M Mielke; Val J Lowe; Prashanthi Vemuri; Mary M Machulda; Christopher G Schwarz; Jeffrey L Gunter; Matthew L Senjem; Jonathan Graff-Radford; David T Jones; Rosebud O Roberts; Walter A Rocca; Ronald C Petersen Journal: JAMA Date: 2019-06-18 Impact factor: 56.272
Authors: Rosebud O Roberts; Yonas E Geda; David S Knopman; Ruth H Cha; V Shane Pankratz; Bradley F Boeve; Robert J Ivnik; Eric G Tangalos; Ronald C Petersen; Walter A Rocca Journal: Neuroepidemiology Date: 2008-02-07 Impact factor: 3.282
Authors: Sergio Grosu; Roberto Lorbeer; Felix Hartmann; Susanne Rospleszcz; Fabian Bamberg; Christopher L Schlett; Franziska Galie; Sonja Selder; Sigrid Auweter; Margit Heier; Wolfgang Rathmann; Katharina Mueller-Peltzer; Karl-Heinz Ladwig; Annette Peters; Birgit B Ertl-Wagner; Sophia Stoecklein Journal: BMJ Open Diabetes Res Care Date: 2021-06