Flares in rheumatoid arthritis (RA) may increase long-term risk of Alzheimer’s disease and related dementias (AD/ADRD), according to a cohort study published in the Scandinavian Journal of Rheumatology.
Researchers analyzed 774 adults aged 50 or older with newly diagnosed RA and no prior cognitive impairment. Over a median 7.8-year follow-up, 79 patients (10%) developed AD/ADRD. Disease activity was assessed across 12,437 medical visits: 27.4% occurred during flares, 23.3% during remission, and 49.3% with moderate activity. While overall findings did not reach statistical significance, there was a trend toward increased dementia risk during flare periods.
Importantly, in current and former smokers, higher cumulative erythrocyte sedimentation rates were significantly linked to dementia risk—an association that remained even after adjusting for cardiovascular disease. This suggests inflammation and smoking may jointly influence cognitive decline in RA patients.
Most patients in flare were seropositive and many exhibited large joint swellings, highlighting an inflammatory phenotype. Although the study’s observational design and reliance on medical records pose limitations, the results emphasize the need to control RA activity not just for joint preservation but potentially for cognitive protection as well.
Researchers caution that while causality is unproven, the link between RA flares and cognitive health warrants further investigation.
