Cognitive impairment in individuals with rheumatic diseases: the role of systemic inflammation, immunomodulatory medications, and comorbidities.

IF 15 1区医学 Q1 RHEUMATOLOGY Lancet Rheumatology Pub Date : 2024-11-11 DOI:10.1016/S2665-9913(24)00190-5

Elena Myasoedova, Sebastian E Sattui, Jiha Lee, John T O'Brien, Una E Makris

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Abstract

Inflammation is an important risk factor, a potential therapeutic target for cognitive decline and dementia, and an inherent feature of autoimmune and immune-mediated rheumatic diseases. The risk of cognitive impairment and dementia is increased in individuals with immune-mediated rheumatic diseases, particularly in those with cardiovascular risk factors and cardiovascular disease. Immunomodulatory medications have been associated with a reduced risk of dementia, but whether this effect is mediated through their anti-inflammatory immunomodulating properties or other mechanisms, such as cardiovascular risk reduction, is unclear. A better understanding of the role of chronic inflammation as a modifiable risk factor for cognitive performance in rheumatic diseases will help inform opportunities for the management of cognitive impairment in people with rheumatic diseases and other chronic inflammatory diseases. In this Series paper, we discuss the epidemiology, risk factors, and current evidence on the role of immunomodulatory medications in cognitive impairment and dementia in people with rheumatic diseases.

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风湿病患者的认知障碍：全身炎症、免疫调节药物和合并症的作用。

炎症是一个重要的风险因素，是认知能力下降和痴呆症的潜在治疗靶点，也是自身免疫性疾病和免疫介导的风湿性疾病的固有特征。患有免疫介导的风湿病的人，尤其是有心血管风险因素和心血管疾病的人，认知障碍和痴呆的风险会增加。免疫调节药物与降低痴呆症风险有关，但这种效应是通过其抗炎性免疫调节特性还是其他机制（如降低心血管风险）介导的，尚不清楚。更好地了解慢性炎症作为可改变风湿性疾病患者认知能力的风险因素所起的作用，将有助于为管理风湿性疾病和其他慢性炎症性疾病患者的认知障碍提供参考。在本系列论文中，我们将讨论免疫调节药物在风湿性疾病患者认知障碍和痴呆症中的流行病学、风险因素和现有证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lancet Rheumatology RHEUMATOLOGY-

CiteScore

34.70

自引率

3.10%

发文量

279

期刊介绍： The Lancet Rheumatology, an independent journal, is dedicated to publishing content relevant to rheumatology specialists worldwide. It focuses on studies that advance clinical practice, challenge existing norms, and advocate for changes in health policy. The journal covers clinical research, particularly clinical trials, expert reviews, and thought-provoking commentary on the diagnosis, classification, management, and prevention of rheumatic diseases, including arthritis, musculoskeletal disorders, connective tissue diseases, and immune system disorders. Additionally, it publishes high-quality translational studies supported by robust clinical data, prioritizing those that identify potential new therapeutic targets, advance precision medicine efforts, or directly contribute to future clinical trials. With its strong clinical orientation, The Lancet Rheumatology serves as an independent voice for the rheumatology community, advocating strongly for the enhancement of patients' lives affected by rheumatic diseases worldwide.