Background/Aims Over the past decade our understanding of the prevalence, and indeed impact, of cognitive impairment in rheumatic diseases has increased. An aging population coupled with systemic inflammation have been postulated as key drivers of increased cognitive decline in these conditions. Intact cognitive function is imperative not only for quality of life and maintenance of one’s functional capacity, but also for the successful therapeutic management of disease, namely the adherence to treatment regimens. The prevalence of cognitive impairment in community dwelling adults above the age of 65 in Ireland has been estimated at 13%.1 To date, the prevalence of cognitive impairment in PMR has not been studied. The aim of this research is therefore to explore the prevalence and potential associated factors of cognitive impairment in those with PMR. Methods Patients with a diagnosis of PMR (fulfilling the 2012 EULAR/ACR Provisional Classification Criteria) who were in clinical remission and on active treatment with glucocorticoids were recruited from two centres. Patients were >3 months and <12 months from diagnosis. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) test which was conducted by trained interviewers. Cognitive impairment was defined by the previously validated MoCA cut-off score of < 26. Demographics, clinical and laboratory data, in addition to patient reported outcomes (PROs) were collected. PROs included anxiety using the Generalised Anxiety Disorder Assessment (GAD-7), mood using the Patient Health Questionnaire (PHQ-9), fatigue using the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F), pain using the visual analogue scale (VAS) and overall health-related quality of life using the Health Assessment Questionnaire-Disability Index (HAQ-DI). The associations between categorical variables were compared using the -test or Fishers exact test. The association between continuous variables and categorical variables were assessed using the Kruskal-Wallis test. Correlations were calculated using Pearson’s r. All analyses were conducted using R (R Core Team, 2022). A p-value of < 0.05 was considered as statistically significant. Results 51 consecutive patients with PMR were recruited, of which 56.9% (n = 29) were female. 70.6% (n = 36) of patients were cognitively impaired, with visuo-spatial, delayed recall and abstraction the most commonly affected cognitive domains. Interestingly, those with cognitive impairment had a younger age, versus those without (p = 0.514). Although not statistically significant, median BMI, anxiety, depression and pain scores were all higher in those who were cognitively impaired. Moreover, median fatigue scores were also worse in the cognitively impaired group. No statistically significant difference in serum markers was observed. Conclusion This study demonstrates that the burden of cognitive impairment in PMR is significant, and is markedly higher than that observed usually at population level. Future studies exploring specific etiologic contributors are needed. Disclosure P. Harkins: Grants/research support; British Society for Rheumatology. S. Cowley: None. R. Harrington: None. D. Kane: None. R. Conway: None.

中文翻译：

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P183 风湿性多肌痛的认知功能

背景/目标 在过去的十年中，我们对风湿性疾病认知障碍的患病率及其影响的了解有所增加。人口老龄化加上全身炎症被认为是这些情况下认知能力下降加剧的关键驱动因素。完整的认知功能不仅对于生活质量和维持功能能力至关重要，而且对于疾病的成功治疗管理（即坚持治疗方案）也至关重要。据估计，爱尔兰 65 岁以上社区居民的认知障碍患病率为 13%。1 迄今为止，尚未对 PMR 中认知障碍的患病率进行研究。因此，本研究的目的是探讨 PMR 患者认知障碍的患病率和潜在相关因素。方法 从两个中心招募诊断为 PMR（符合 2012 年 EULAR/ACR 临时分类标准）且处于临床缓解状态并正在接受糖皮质激素积极治疗的患者。患者诊断后时间≥3个月和≤12个月。认知功能通过蒙特利尔认知评估（MoCA）测试进行评估，该测试由经过培训的访谈员进行。认知障碍的定义是先前验证的 MoCA 截止分数＜1。 26. 除了患者报​​告结果（PRO）之外，还收集了人口统计数据、临床和实验室数据。 PRO 包括使用广泛性焦虑症评估 (GAD-7) 的焦虑、使用患者健康问卷 (PHQ-9) 的情绪、使用慢性病治疗疲劳量表 (FACIT-F) 的功能评估的疲劳、使用视觉模拟的疼痛使用健康评估问卷-残疾指数 (HAQ-DI) 衡量与健康相关的总体生活质量。使用 检验或 Fisher 精确检验比较分类变量之间的关联。使用 Kruskal-Wallis 检验评估连续变量和分类变量之间的关联。使用 Pearson's r 计算相关性。所有分析均使用 R（R 核心团队，2022）进行。 p值<= 0.05被认为具有统计显着性。结果 连续招募了 51 名 PMR 患者，其中 56.9%（n = 29）为女性。 70.6% (n = 36) 的患者存在认知障碍，其中视觉空间、延迟回忆和抽象是最常受影响的认知领域。有趣的是，患有认知障碍的人比没有认知障碍的人年龄更小（p = 0.514）。尽管没有统计学意义，但认知障碍患者的体重指数中位数、焦虑、抑郁和疼痛评分均较高。此外，认知障碍组的疲劳评分中位数也更差。未观察到血清标志物有统计学上的显着差异。结论 这项研究表明 PMR 认知障碍的负担是显着的，并且明显高于通常在人口水平上观察到的水平。未来的研究需要探索特定的病因学因素。披露 P. Harkins：赠款/研究支持；英国风湿病学会。 S.考利：没有。 R.哈林顿：没有。 D·凯恩：没有。 R.康威：没有。