Association of Use of Rehabilitation Services With Development of Dementia Among Patients With Rheumatoid Arthritis: Analysis of Domestic Data in Taiwan

Abstract

Objectives: Rheumatoid arthritis (RA) was found to trigger the higher risk of dementia. Limited information, however, is available on whether the use of rehabilitation services (RS), an integral part of healthcare programs, can lessen dementia risk for RA subjects. The aim of this study was to determine the relationship of RS use to the development of dementia in RA patients. Methods: We identified 2,927 newly diagnosed patients with RA, 20-70 years of age between 1998 and 2007, from a national health insurance database. 965 patients from this sample received RS, and 1,962 patients were designated as a control group (non-RS users). Patients were followed to the end of 2012 to identify dementia incident as the end point. Cox proportional hazards regression was performed to calculate the hazard ratio (HR) of dementia risk associated with the use of RS. Results: During the study period, 388 patients with RS and 1,224 controls developed dementia, representing incidence rate of 75.46 and 115.42 per 1,000 person-years, respectively. After adjusting for potential confounders, RS was found to significantly reduce dementia risk, with the adjusted HR of 0.60 (95% confidence interval [CI] = 0.53-0.67). Those who used the high intensity of RS (≧15 courses) had the greatest benefit. Conclusions: Integrating RS into the conventional treatment may reduce the sequent risk of dementia for RA patients.

Effect of Chinese Herbal Medicines on Hearing Loss Risk in Rheumatoid Arthritis Patients: Retrospective Claims Analysis

“…Second, a reliable index of RA severity was unavailable from the LHID, and failure to control for this factor may bias the findings. To address this potential problem, we performed two sensitivity analyses: one limited the analysis to the patients without comorbidity, and the other added the prescription of biological agents for 6 months or longer, a common surrogate used for RA severity ( 34 , 35 ), to the analyses. These sensitivity analyses support that disease severity was not likely to introduce a remarkable effect on our conclusion—adding CHM to conventional therapy may reduce the subsequent risk of HL in RA patients.…”