SAT0375 MILD COGNITIVE IMPAIRMENTIN PSORIATIC ARTHRITIS: PREVALENCE AND ASSOCIATED FACTORS
Authors: Marco Di Carlo, Andrea Becciolini, Antonella Incorvaia, Giacomo Beci, Martina Biggioggero, Ennio Giulio Favalli, Fausto Salaffi
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> A growing body of data demonstrated that systemic inflammation is a predisposing condition for developing cognitive impairment. Different studies highlighted that psoriasis (PsO), a multisystem chronic inflammatory disorder, is associated with cognitive impairment. No data are available regarding psoriatic arthritis (PsA). <h3>Objectives:</h3> To assess the prevalence and the factors associated with mild cognitive impairment (MCI) in patiens suffering from PsA. <h3>Methods:</h3> Consecutive PsA patients, classified as suffering from PsA with the ClASsification criteria for Psoriatic ARthritis (CASPAR), were enrolled in this study. For each patient were collected the sociodemographic data (age, gender, years of school attendance, years of articular disease duration, years of cutaneous disease duration, treatment), the values of C-reactive protein (CRP) and the following clinical variables: 68 tender joint count (TJC), 66 swollen joint count (TJC), the Leeds Enthesitis Index (LEI), the dactylitis digit count, the Psoriasis Area and Severity Index (PASI), 10 cm numerical rating scale (NRS) for pain and for assessment of disease activity (PaGA), the Dermatology Life Quality Index (DLQI), the 12-item Psoriatic Arthritis Impact of Disease (PsAID-12), the Health Assessment Questionnaire (HAQ), and the Self-admistered Comorbidity Questionnaire (SCQ). Cognitive impairment was assessed through the Montreal Cognitive Assessment (MoCA). The exclusion criteria were represented by the presence of: age older than 70 years, major depressive disorder, dementia, Parkinson's disease, active skin disease other than PsO, concomitant inflammatory joint conditions (such as gout or calcium pyrophosphate deposition), and comorbid fibromyalgia. <h3>Results:</h3> The study involved 96 PsA patients, with a mean age of 52.8 years. Twenty (20.8%) patients were suffering from PsA sine PsO. The mean articular disease duration was 9.9 years, and the mean cutaneous disease duration was 14.9 years. The mean Disease Activity index for Psoriatic Arthritis (DAPSA) was 11.8, and the mean PASI was 0.95. MCI (defined as a MoCA score &lt;26/30) was detected in 47 (48.9%) patients, with a mean value of MoCA of 25.1±3.1. Short-term memory was the most affected domain (mean value 2.6 on 0-5 point scale). The variables under investigation significantly correlated with a worsening cognitive performance (Spearman's Rho) were functional capacity (MoCA vs HAQ, r<sub>s</sub> = -0.227, p = 0.026) and fatigue (MoCA vs PsAID item 2, r<sub>s</sub> = -0.222, p = 0.029). <h3>Conclusion:</h3> MCI is present in a significant proportion of PsA patients, and is present in a relative young age. MCI occurrence is associated with the presence of a worse functional capacity and a greater fatigue. Short-term memory is the more frequently affected domain. Although not predominantly of rheumatological interest, the MCI presence should be carried out in all patients with PsA. <h3>References</h3> [1] Gisondi P, Sala F, Alessandrini F, et al. Mild cognitive impairment in patients with moderate to severe chronic plaque psoriasis. Dermatology. 2014;228(1):78-85. [2] Colgecen E, Celikbilek A, Keskin DT. Cognitive Impairment in Patients with Psoriasis: A Cross-Sectional Study Using the Montreal Cognitive Assessment. Am J Clin Dermatol. 2016;17(4):413-9. <h3>Disclosure of Interests:</h3> Marco Di Carlo: None declared, Andrea Becciolini: None declared, Antonella Incorvaia: None declared, giacomo beci: None declared, Martina Biggioggero: None declared, Ennio Giulio Favalli: None declared, Fausto Salaffi Grant/research support from: Abbvie, Roche, Novartis, BMS, Pfizer, Sanofi, Speakers bureau: Abbvie, Roche, Novartis, Pfizer, Sanofi, BMS