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Mo, Park, and Oh: Correlates of Cognitive Impairment of Rheumatic Disease: Systematic Review and Meta-analysis
Review Article

Journal of Korean Academy of Nursing 2016; 46(1): 1-18.

Published online: 29 February 2016

DOI: https://doi.org/10.4040/jkan.2016.46.1.1

Correlates of Cognitive Impairment of Rheumatic Disease: Systematic Review and Meta-analysis

JinA Mo1, JiSuk Park2, HyunSoo Oh3

1National Evidence-based Health Care Collaborating Agency, Seoul, Korea.

2Department of Nursing, Inha University Hospital, Incheon, Korea.

3Department of Nursing, Inha University, Incheon, Korea.

Address reprint requests to: Oh, HyunSoo. Department of Nursing, Inha University, 100 Inha-ro, Nam-gu, Incheon 22212, Korea. Tel: +82-32-860-8206, Fax: +82-32-874-5880, hsoh@inha.ac.kr

Received 3 February 2015       Revised 25 February 2015       Accepted 11 October 2015

© 2016 Korean Society of Nursing Science

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0/) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This study was conducted to synthesis the results of research on relationships of cognitive impairment with multi-dimensional correlates of rheumatic disease through a systematic literature review and meta-analysis.

Methods

For the study purpose, 23 studies were selected through a systematic process of searching the literature.

Results

The study results showed that among general characteristics, age and education were the variables having a significant relationship with cognitive impairment. Among health risk factors, obesity appeared to have a significant positive relationship with cognitive impairment. For past history, diabetes and hypertension were shown to have a significant positive relationship with cognitive impairment. It was noted also that aPL, one of the physiological factor, had significant association with cognitive impairment. None of the medication related factors had a significant relationship with cognitive impairment. Results showed that among disease related factors, disease activity had the highest relationship with cognitive impairment. Depression, among psychological factors, was the only variable having a significant relationship with cognitive impairment.

Conclusion

The findings indicate that the variables strongly impacting on cognitive impairment in rheumatic disease are depression and disease activity.

Keywords: Cognition disorders, Rheumatic diseases, Review, Meta-analysis

Figures and Tables

Figure 1

Flow diagram for study selection.

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Figure 2

Funnel plot for publication bias.

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Figure 3

Forest plot of each correlates of cognitive impairment.

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Table 1

General Characteristics of Studies included in Meta-analysis (N =3,487)

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Corr=Correlational study; Case=Case control study design; Lupus=Systemic lupus erythematousus; FM=Fibromyalgia; RA: Rheumatoid arthritis; MMSE=Mini Mental State Examination; MoCA=Montreal Cognitive Assessment; SCID-I=Structured Clinical Interview for DSM-IV Axis I; PDQ=Perceived Deficit Questionnaire; Battery=Neuropsychological Battery; GCDs=Global Cognitive Dysfunction score; WAIS-R=Wechsler Adult Intelligence Scale-Revised; Hopkins=Hopkins scale; ANAM=Automated Neuropsychological Assessment Matrics.

Table 2

Meta-Analysis of Correlates of Cognitive Impairment in Rheumatic Disease (N =3,487)

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*Mean weighted correlation coefficient; †Rheumatoid arthritis and fibromyalgia; ‡The factor indicated age, sex, education, economic status, vocational level (economical and vocational status were excluded in analysis because less than 3 studies included these variables); §The factor indicated smoking and obesity (measured with index of BMI, waist circumference, muscle mass) (smoking was excluded in analysis because less than 3 studies included this variable); ∥The factor included aPL, Ch/Cr, and anti-cardiolipin IgM (Ch/Cr and anti-cardiolipin IgM were excluded in the analysis because less than 3 studies included these variables); The factor included aspirine, prednisolone, and cyclophosphamid (prednisolone and cyclophosphamid were excluded in the analysis because less than 3 studies included these variables); The factor included anxiety, depression, and stress (stress was excluded in the analysis because less than 3 studies included this variable).

Notes

This study was supported by 2015 Inha University Research Fund (No. 52754).

CONFLICTS OF INTEREST The authors declared no conflict of interest.

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