Romatoid artritli hastalarda kognitif bozukluk ve depresyon, yorgunluk, uyku ve yaşam kalitesinin korelasyonu
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Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Romatoid Artrit (RA) hastalarında ekstraartiküler tutulum sık gözlenmekle birlikte nörolojik tutulum daha azdır. Bununla birlikte son yıllarda RA'li hastalarda kognitif fonksiyon bozukluğunun normal popülasyona göre sık olduğu bildirilmiş fakat neden sonuç ilişkisi aydınlatılamamıştır. Bu çalışmanın amacı RA'li hastalarda kognitif fonksiyon bozukluğu ile yorgunluk, anksiyete, depresyon ve uyku bozukluğu arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Bu çalışma RA hastalarının dahil edildiği kesitsel vaka kontrol çalışmasıdır. Çalışmamızda RA tanılı hastalar ile kontrol grubu demografik veriler açısından sorgulandı, hastaların kullandıkları ilaçlar ve hastalık süresi kaydedildi. Hastaların kognitif parametrelerini değerlendirmek için Montreal Bilişsel değerlendirme anketi (MOCA), Standardize Mini Mental test (MMSE), Sayı menzili testi (Digit Span test) , Stroop Renk Kelime Karıştırma Testi kullanıldı. Ayrıca her iki Hastane depresyon ve anksiyete skoru (HADS), Yorgunluk şiddet ölçeği (YŞÖ), Pittsburgh uyku kalite indeksi ve(PUKİ), açık şeklini yazalım (HAQ), ağrı vizüel analog skalası (VAS) kullanıldı. RA grubuna bunlara ek olarak hastalık aktivite skorunun belirlenmesi için hastalık aktivite skoru 28 (DAS 28) ve yaşam kalitesi değerlendirilmesi için RAQOL kullanıldı. Bulgular: Çalışmaya yaş ortalaması 18 -60 yıl olan 65 RA'li hasta ve cinsiyet, yaş, eğitim durumu açısından uyumlu 60 sağlıklı kontrol dahil edildi. Tüm kognitif testlere göre kıyaslandığında RA grubunda sağlıklı kontrole göre kognitif testler istatistiksel olarak olumsuz etkilenmişti (p < 0.005). Ayrıca HADS, YŞÖ, PUKİ, VAS, HAQ puanları da kontrol grubuna göre RA grubunda istatistiksel olarak negatif etkilenmişti (p < 0.005). Regresyon analizinde kadın cinsiyet, yaş, sigara, hastalık yaşı, eğitim süresi, ağrı, TNF- ? inhibitörü ve PLQ kullanımı ile kognitif parametreler arasında anlamlı ilişki bulundu (p < 0.005). Sonuçlar: Elde edilen veriler RA hastalarında kognitif parametrelerin etkilenebileceğini ve bununla ilişkili olabilecek faktörleri ortaya koydu. Ortaya konan bu faktörlerin daha ileri çalışmalarda araştırılması, neden sonuç ilişkisinin ortaya konmasının hastaların tedavi seçeneği, günlük yaşam kalitesinin düzenlenmesi açısından önem arz etmektedir. Anahtar Kelimeler: Romatoid artrit, kognitif disfonksiyon, yaşam kalitesi
Objective: Although extra-articular involvement is frequently observed in patients with rheumatoid arthritis (RA), neurological involvement is less. However, in recent years, it has been reported that cognitive dysfunction is more common in patients with RA compared to the normal population, but the cause-effect relationship has not been clarified. The aim of this study is to investigate the relationship between cognitive dysfunction and fatigue, anxiety, depression and sleep disturbance in patients with RA. Material and methods: This is a cross-sectional case-control study of RA patients. Patients diagnosed with RA and the control group were questioned in terms of demographic data. In addition, the drugs used by the patients with RA and the duration of the disease were recorded. In the study, Montreal Cognitive Assessment Questionnaire (MOCA), Standardized Mini Mental Test (MMSE), Digit Span Test, Stroop color and word interference test were used to evaluate cognitive parameters. In addition, there was used hospital depression and anxiety score (HADS) for evaluation of depression and anxiety, Fatigue severity scale (FSS) for fatigue, Pittsburgh sleep quality index (PUKI) for evaluation of sleep quality, HAQ for evaluation of quality of life, and visual analog for evaluation of pain scale (VAS). In addition to these, disease activity score 28 (DAS 28) was used to determine the disease activity score in the RA group and RAQOL was used to evaluate the quality of life. Factors that were significant predictive in univariate analysis were evaluated in multiple regression analysis. Findings: The study included 65 patients with RA and 60 healthy controls with a mean age of 18-60 years who were matched in terms of gender, age, and educational status. When compared with all cognitive tests, cognitive tests were statistically negatively affected in the RA group compared to the healthy control (p < 0.005). HADS, FSS, PUKI, VAS, HAQ scores were also statistically negatively affected in the RA group compared to the control group (p < 0.005). In the regression analysis, a correlation was shown between female gender, age, smoking, age of disease, education period, pain, use of TNF- ? inhibitor and PLQ and cognitive parameters (p < 0.005). Conclusion: The obtained data revealed that cognitive parameters can be affected in the RA patients and factors that may be related to this. It is important to investigate these factors in further studies and to reveal the cause-effect relationship in terms of the treatment option of the patients and the regulation of their daily life quality. Keywords: rheumatoid arthritis, cognitive dysfunction, life quality
Objective: Although extra-articular involvement is frequently observed in patients with rheumatoid arthritis (RA), neurological involvement is less. However, in recent years, it has been reported that cognitive dysfunction is more common in patients with RA compared to the normal population, but the cause-effect relationship has not been clarified. The aim of this study is to investigate the relationship between cognitive dysfunction and fatigue, anxiety, depression and sleep disturbance in patients with RA. Material and methods: This is a cross-sectional case-control study of RA patients. Patients diagnosed with RA and the control group were questioned in terms of demographic data. In addition, the drugs used by the patients with RA and the duration of the disease were recorded. In the study, Montreal Cognitive Assessment Questionnaire (MOCA), Standardized Mini Mental Test (MMSE), Digit Span Test, Stroop color and word interference test were used to evaluate cognitive parameters. In addition, there was used hospital depression and anxiety score (HADS) for evaluation of depression and anxiety, Fatigue severity scale (FSS) for fatigue, Pittsburgh sleep quality index (PUKI) for evaluation of sleep quality, HAQ for evaluation of quality of life, and visual analog for evaluation of pain scale (VAS). In addition to these, disease activity score 28 (DAS 28) was used to determine the disease activity score in the RA group and RAQOL was used to evaluate the quality of life. Factors that were significant predictive in univariate analysis were evaluated in multiple regression analysis. Findings: The study included 65 patients with RA and 60 healthy controls with a mean age of 18-60 years who were matched in terms of gender, age, and educational status. When compared with all cognitive tests, cognitive tests were statistically negatively affected in the RA group compared to the healthy control (p < 0.005). HADS, FSS, PUKI, VAS, HAQ scores were also statistically negatively affected in the RA group compared to the control group (p < 0.005). In the regression analysis, a correlation was shown between female gender, age, smoking, age of disease, education period, pain, use of TNF- ? inhibitor and PLQ and cognitive parameters (p < 0.005). Conclusion: The obtained data revealed that cognitive parameters can be affected in the RA patients and factors that may be related to this. It is important to investigate these factors in further studies and to reveal the cause-effect relationship in terms of the treatment option of the patients and the regulation of their daily life quality. Keywords: rheumatoid arthritis, cognitive dysfunction, life quality
Açıklama
Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Ana Bilim Dalı
Anahtar Kelimeler
Fiziksel Tıp ve Rehabilitasyon, Physical Medicine and Rehabilitation
