OP0134 ACTIVE RHEUMATOID ARTHRITIS AND ASSOCIATED COMORBIDITIES INCREASE RISK OF DEMENTIA: A POPULATION-BASED COHORT STUDY

Background Growing evidence from observational studies indicates that patients with rheumatoid arthritis (RA) have a higher risk of developing dementia. However, the incidence dementia among RA has declined in recent years 1 . It is unknown if this reflects broader trends over time, changes prevalence or treatment associated comorbidities, advances yielding better control inflammation RA, other factors (e.g., environmental factors). Longitudinal population-based assessing for are scarce 2 Objectives We aimed to identify incident large inception cohort RA. Methods This retrospective study included residents Olmsted County, MN, who were ≥50 when they met 1987 ACR criteria 1980-2014. All individuals followed until death/migration 12/31/2019. Patients before excluded (n=12). Incident was defined as two relevant ICD-9/10 codes at least 30 days apart. Risk including socio-demographics, disease characteristics and medications, cardiovascular/cerebrovascular (CVD) comorbidities abstracted medical records. Any CVD coronary heart (i.e., angina pectoris, artery disease, myocardial infarction, revascularization procedures, cerebral stroke failure (HF). Association individual examined using Cox proportional hazard models. Three models utilized: Model 1, adjusting age, sex, calendar year incidence; 2, adding smoking, obesity, hypertension, diabetes mellitus, hyperlipidemia first; 3, ‘any CVD’ second. Time-dependent covariates used represent developed during follow-up. Results The 886 (mean age 65 years, 65% females). During follow-up period (median=8.5 years), 103 Mean diagnosis 82.3 (7.2) years. cumulative increased by 2-3% every 5 after Older (Hazard Ratio (HR) 1.14 per increase, confidence interval (CI): 1.12-1.17) consistently Presence nodules (HR 1.76, CI: 1.05-2.95), joint swelling 2.11, 1.33-3.34), hypertension 1.84, 1.19-2.85), HF 2.72, 1.29-5.74), depression 2.23, 1.36-3.67) baseline first significantly Large 2.03, 1.14-3.60), any 2.25, 1.38-3.66), anxiety 1.86, 1.16-2.97), 2.63, 1.76-3.93) time Among conditions, 3.16, 1.84-5.43) 1.82, 1.10-3.00) After (Model 2), plus 3), all listed above still Conclusion Apart (particularly hypertension), anxiety, which universally recognized dementia, we observed clinically active an elevated patients. Studies ongoing further evaluate role systemic its interactions overall subtype References [1]Kronzer V L et al. Trends arthritis: A population based study. Semin. Arthritis Rheum. 51, 853–857 (2021) [2]Wallin K Midlife increases cognitive impairment decades later: J. Alzheimer’s Dis. 31, 669–676 (2012) Acknowledgements work supported grants National Institutes Health, NIAMS (R01 AR46849) NIA AG068192, R01 AG034676). Disclosure Interests Chanakya Kodishala: None declared, Cassondra Hulshizer: Vanessa Kronzer: John M Davis III Grant/research support from: Pfizer, Vijay Ramanan: Maria Vassilaki Shareholder of: Abbott Laboratories, Johnson Johnson, Medtronic, Amgen, Consultant F. Hoffmann-La Roche Ltd, Ltd Biogen, Michelle Mielke Brain Protection Company, LabCorp, Cynthia S. Crowson: Elena Myasoedova: declared