Rheumatoid arthritis treatments may reduce the risk of dementia

Rheumatoid arthritis treatments may reduce the risk of dementia

Curbing inflammation may be key.

Rheumatoid arthritis (RA) is an autoimmune condition that affects up to 3% of the population. Arthritis, a hallmark of the disease, causes swelling, stiffness, and limited movement, especially in the small joints of the hands and wrists.

But the inflammation in rheumatoid arthritis is not limited to the joints – it is found throughout the body. For example, skin nodules, eye inflammation, and lung scarring are well-known features of rheumatoid arthritis, all of which are associated with uncontrolled inflammation. Interestingly, inflammation may play a major role in dementia. So, could anti-inflammatory drugs for rheumatoid arthritis affect the odds of developing dementia?

Can rheumatoid arthritis treatment reduce dementia risk?

Recent studies suggest that the answer may be yes. Perhaps this should not be surprising. The role of inflammation in Alzheimer’s disease and other types of dementia Research focus for decadesRheumatoid arthritis treatments reduce inflammation.

Given that there are currently no effective preventative treatments for Alzheimer’s disease or other forms of dementia, the observation that rheumatoid arthritis treatments may prevent dementia could be groundbreaking.

What evidence supports this idea? Here are some of the latest and most compelling observational studies.

  • A study published in 2019 reported that people with rheumatoid arthritis were treated with standard medications Less than half the risk of dementia over five years compared to people without rheumatoid arthritis.
  • A 2021 study found rates of dementia It decreased among people with RA and increased among the general population in recent decades. During that time, rheumatoid arthritis treatments were getting better.
  • 2022 study looking at people who take Different types of rheumatoid arthritis treatment It offers some of the most compelling results. It found that people with rheumatoid arthritis who took the newest and most effective treatments developed dementia at a 19% lower rate over the three years of the study than those treated with older medications. When people taking a combination of the new drugs were compared, there was no significant difference in the rate of dementia.

Taken together, these studies suggest that some treatments that help treat rheumatoid arthritis may do more than protect the joints. It may also protect the brain. This is not the first time that a drug has been found to cause Unexpectedly positive side effects. But it could be one of the most important.

Is additional research needed?

While evidence is mounting that anti-inflammatory drugs may reduce the risk of developing dementia, more research is needed:

  • Observational studies cannot prove the cause. They simply note rates of dementia among different groups of people, which means that other factors could be responsible for the results. For example, the 2022 study did not assess smoking and family history, which contribute to dementia. If the group receiving older rheumatoid arthritis treatments had more risk factors for dementia, the medications might not explain the results. The most robust evidence comes from randomized controlled trials, where similar people are randomly assigned to different treatment groups and their health is analyzed over time.
  • Results may vary with different or more diverse groups of study participants. For example, participants in the 2022 study were elderly (median age 67), mostly white (75%), and mostly female (80%).
  • Independent research is necessary to confirm the results. Rarely is a single study from a single group of researchers convincing, especially on an issue as important as the prevention of dementia.
  • Long-term follow-up is needed. Rheumatoid arthritis is a lifelong disease, so studies lasting three to five years may not tell the whole story.
  • We’re not sure how some medications for rheumatoid arthritis might protect the brain. We also don’t know if these treatments can be effective for people who don’t have rheumatoid arthritis.

It is reasonable to believe that reducing inflammation, rather than a specific medication, provides a benefit because different medications with different ways of suppressing inflammation have been associated with a reduced risk of dementia in people with rheumatoid arthritis. But we will need more research to prove that this is true.

bottom line

Treatments developed over the past 50 years have transformed rheumatoid arthritis from a disease that often leads to disabling into a chronic, usually well-controlled condition. The initial choice of treatment depends on a range of factors, including effectiveness, profile of side effects, how the drug is given (most people prefer pills over injections), cost, and whether the drug is covered by health insurance.

Soon, another consideration could be added to this list: the drug’s ability to reduce dementia risk. This may be especially important for someone with rheumatoid arthritis who has a strong family history of dementia.

And what about people who don’t have rheumatoid arthritis? I think it’s only a matter of time before studies explore whether anti-inflammatory drugs can reduce the risk of dementia even in people who don’t have an inflammatory condition like rheumatoid arthritis. While it is impossible to predict what these studies will show, one thing is certain: the impact of a positive study will be enormous.

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