Linda A. Russell, MD, rheumatologist and director of perioperative medicine at HSS, discusses clinical implications of the research findings to date indicating the possible mechanistic links between rheumatoid arthritis (RA) and dementia.

Dr. Russell explained most but not all studies suggest there is an increased risk of dementia in patients with RA. RA is associated with systemic inflammation, which has been shown to be associated with increased cardiovascular disease. It has been shown that RA can increase the risk of myocardial infarction and stroke and felt that the systemic inflammation in RA can be associated with the microvascular disease in vascular dementia.

Several studies also demonstrate that patients on anti-TNF therapy may be somewhat protected from developing dementia, continued Dr. Russell. Anti-TNF therapy has been shown to decrease the risk of cardiovascular disease and bone loss in patients with RA; in both instances, the anti-TNF therapy is felt to decrease inflammation. Some studies have shown a similar effect with DMARDs [disease-modifying antirheumatic drugs], while other studies have not. It is also important to control hypertension, hyperlipidemia, and diabetes, all of which can increase the risk of dementia, she added. Patients should get regular exercise and maintain a healthy weight.

Areas requiring additional research pertaining to this topic include exploration of how to decrease the risk of dementia in RA and the evaluation of biologics, according to Dr. Russell.

Read the full text article at Rheumatologyadvisor.com.