In patients with rheumatoid arthritis (RA), increasing exercise and physical activity reduces inflammation and promotes overall wellbeing, which will ultimately improve cognitive function, according to research published in Cureus.

Researchers from the California Institute of Behavioral Neurosciences & Psychology evaluated the impact of increasing physical activity on cognitive performance in people with RA. They searched several electronic databases including PubMed, MEDLINE, Science Direct, and PubMed Central, to obtain data. After screening and quality appraisal checklist, 12 studies were chosen.

The systemic review found that increasing physical activity can have significant benefits in the RA population. Physical activities such as walking, jogging, and running are proven to reduce the pro-inflammatory leukotrienes in this patient population, the review notes.


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The investigators report that increasing physical activity in patients with RA improves mood, overall well being, and mental health. According to a cohort study they cited, “if patients with RA meet the guidelines for physical activity, it will protect different domains of cognition such as protection against memory, word finding, and concentration.” In addition, yoga, which involves physical and breathing exercises, was found to increase mood and reduce psychological distress in these patients.

Researchers acknowledge that perception of physical activity varies based on the patient. For example, patients experiencing low back pain and rheumatic pain may be apprehensive to perform aerobic exercise. Research the study included showed that targeting such beliefs through education and intervention may help patients with RA become more physically active. The review authors hypothesize that if a patient’s perception about their disorder is effectively addressed, it can reduce their pain perception and increase their willingness to participate in physical activity.

In a cohort study, investigators observed that health-enhancing physical activity, such as 150 minutes of exercise per week and moderate-intensity muscle-strengthening exercises twice a week in patients with RA may be beneficial in conjunction with treatment. In a separate study, investigators found that motivational interviews and self-regulation coaching may aid patients in continuing their physical activity.

The review is not without limitations. The research team noted that they may have missed some important aspects of the study because of the inclusion/exclusion criteria.

“After reviewing published literature related to our research question we concluded several points, that patients with RA and other kinds of inflammatory arthritis have a high burden of inflammation, which is compromising their thought process and self-efficacy towards physical activity,” the review stated. “Counseling and addressing patient concerns are very important and keep disease activity well controlled so that physical activities become feasible.”

Reference

Akram A, Georgiou P, Shi W, et al. Impact of Change in Lifestyle and Exercise on Cognitive Function in Patients With Rheumatoid Arthritis: A Systematic Review. Cureus. Published online September 25, 2021. doi:10.7759/cureus.18268