Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis
Abstract Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint destruction and systemic inflammation, both of which significantly impair patients’ quality of life. Mild cognitive impairment (MCI), a reversible precursor to dementia, is increasingly prevalent am...
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| Language: | English |
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BMC
2025-07-01
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| Series: | BMC Rheumatology |
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| Online Access: | https://doi.org/10.1186/s41927-025-00538-3 |
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| author | Jun Yan Hua Guo Lin-Xin Zhang Pei Chen Yong-Ku Du Juan Li Ya-Ya Gao Nan Ye |
| author_facet | Jun Yan Hua Guo Lin-Xin Zhang Pei Chen Yong-Ku Du Juan Li Ya-Ya Gao Nan Ye |
| author_sort | Jun Yan |
| collection | DOAJ |
| description | Abstract Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint destruction and systemic inflammation, both of which significantly impair patients’ quality of life. Mild cognitive impairment (MCI), a reversible precursor to dementia, is increasingly prevalent among elderly RA patients. Early identification of MCI in this population allows for timely interventions to slow cognitive decline. Objective This study aims to identify independent risk factors for MCI in elderly patients with RA and to develop a predictive nomogram. Methods We enrolled 378 elderly RA patients, aged 60 to 80 years, from Xi’an Fifth Hospital between December 2023 and December 2024. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with scores ranging from 20 to 26 indicating MCI. We analyzed demographic, clinical, and laboratory data to identify risk factors through logistic regression and constructed a nomogram. The model’s performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results Among the 378 patients, 94 (24.87%) were classified in the RA-MCI group. Multivariate analysis identified the course of disease (COD) (OR = 1.07, 95% CI: 1.03–1.10), elevated Disease Activity Score-28 (DAS28) (OR = 1.31, 95% CI: 1.13–1.53), high C-reactive protein (CRP) levels (OR = 1.01, 95% CI: 1.01–1.02), and osteoporosis (OP) (OR = 1.88, 95% CI: 1.14–3.13) as independent risk factors. The nomogram demonstrated moderate discrimination (AUC = 0.750, 95% CI: 0.696–0.805) and clinical utility. Conclusion The COD, OP, DAS28, and CRP levels are key predictors of MCI in elderly RA patients. The proposed nomogram provides a practical tool for early risk stratification, facilitating targeted interventions to delay cognitive decline. Trial registration This study conformed to the principles outlined in the Declaration of Helsinki and received approval from the Medical Ethics Committee of Xi’an Fifth Hospital (Approval No.: [2023] Ethics Review 55). Additionally, the trial was registered with the Chinese Clinical Trial Registry (Registration No.: ChiCTR2300077337, Registration Date: 2023-11-01). Written informed consent was obtained from all individual participants included in the study. |
| format | Article |
| id | doaj-art-3b40887e31584241b1f55652c662673f |
| institution | Kabale University |
| issn | 2520-1026 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Rheumatology |
| spelling | doaj-art-3b40887e31584241b1f55652c662673f2025-08-20T03:42:02ZengBMCBMC Rheumatology2520-10262025-07-019111010.1186/s41927-025-00538-3Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritisJun Yan0Hua Guo1Lin-Xin Zhang2Pei Chen3Yong-Ku Du4Juan Li5Ya-Ya Gao6Nan Ye7Department of Neurology, Xi’an Fifth HospitalDepartment of Neurology, Xi’an Fifth HospitalDepartment of Neurology, Xi’an Fifth HospitalDepartment of Neurology, Xi’an Fifth HospitalDepartment of Radiology, Xi’an Fifth HospitalDepartment of Rheumatology, Xi’an Fifth HospitalDepartment of Neurology, Xi’an Fifth HospitalDepartment of Neurology, Xi’an Fifth HospitalAbstract Background Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by joint destruction and systemic inflammation, both of which significantly impair patients’ quality of life. Mild cognitive impairment (MCI), a reversible precursor to dementia, is increasingly prevalent among elderly RA patients. Early identification of MCI in this population allows for timely interventions to slow cognitive decline. Objective This study aims to identify independent risk factors for MCI in elderly patients with RA and to develop a predictive nomogram. Methods We enrolled 378 elderly RA patients, aged 60 to 80 years, from Xi’an Fifth Hospital between December 2023 and December 2024. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), with scores ranging from 20 to 26 indicating MCI. We analyzed demographic, clinical, and laboratory data to identify risk factors through logistic regression and constructed a nomogram. The model’s performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA). Results Among the 378 patients, 94 (24.87%) were classified in the RA-MCI group. Multivariate analysis identified the course of disease (COD) (OR = 1.07, 95% CI: 1.03–1.10), elevated Disease Activity Score-28 (DAS28) (OR = 1.31, 95% CI: 1.13–1.53), high C-reactive protein (CRP) levels (OR = 1.01, 95% CI: 1.01–1.02), and osteoporosis (OP) (OR = 1.88, 95% CI: 1.14–3.13) as independent risk factors. The nomogram demonstrated moderate discrimination (AUC = 0.750, 95% CI: 0.696–0.805) and clinical utility. Conclusion The COD, OP, DAS28, and CRP levels are key predictors of MCI in elderly RA patients. The proposed nomogram provides a practical tool for early risk stratification, facilitating targeted interventions to delay cognitive decline. Trial registration This study conformed to the principles outlined in the Declaration of Helsinki and received approval from the Medical Ethics Committee of Xi’an Fifth Hospital (Approval No.: [2023] Ethics Review 55). Additionally, the trial was registered with the Chinese Clinical Trial Registry (Registration No.: ChiCTR2300077337, Registration Date: 2023-11-01). Written informed consent was obtained from all individual participants included in the study.https://doi.org/10.1186/s41927-025-00538-3AgingRheumatoid arthritisMild cognitive impairmentPredictive model |
| spellingShingle | Jun Yan Hua Guo Lin-Xin Zhang Pei Chen Yong-Ku Du Juan Li Ya-Ya Gao Nan Ye Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis BMC Rheumatology Aging Rheumatoid arthritis Mild cognitive impairment Predictive model |
| title | Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| title_full | Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| title_fullStr | Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| title_full_unstemmed | Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| title_short | Risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| title_sort | risk factors and predictive model for mild cognitive impairment in elderly patients with rheumatoid arthritis |
| topic | Aging Rheumatoid arthritis Mild cognitive impairment Predictive model |
| url | https://doi.org/10.1186/s41927-025-00538-3 |
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