ASSESSMENT OF COGNITIVE FUNCTION AMONG ALDOLESCENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
DOI:
https://doi.org/10.71000/qwh9rq20Keywords:
MMSE, Cognition , Juvenile Idiopathic arthritis, Adolescent, Cognitive Dysfunction, Neuropsychological Tests, Quality of LifeAbstract
Background: Juvenile idiopathic arthritis (JIA) is a chronic autoimmune condition that affects children and adolescents, primarily targeting synovial joints and causing inflammation, pain, and swelling. While its physical manifestations are well-documented, growing evidence indicates that chronic systemic inflammation may also impact cognitive development. Adolescents with JIA may experience impairments in memory, attention, and executive function, which can significantly influence academic performance and overall quality of life. Early identification of cognitive deficits is essential for timely interventions and holistic disease management.
Objective: To assess cognitive function in adolescents diagnosed with juvenile idiopathic arthritis using a standardized cognitive assessment tool.
Methods: A cross-sectional study was conducted over six months at three tertiary care hospitals in Lahore. Using purposive sampling, 100 adolescents aged 10–14 years with confirmed diagnoses of JIA were recruited. Inclusion criteria consisted of both male and female patients diagnosed with JIA, while those with systemic illnesses or developmental disorders were excluded. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE), a structured tool administered by trained personnel. Data were recorded using a predesigned standardized questionnaire and analyzed descriptively.
Results: The mean age of participants was 11.95 ± 1.23 years, with a mean height of 4.91 ± 0.19 feet and mean weight of 48.20 ± 2.42 kg. Gender distribution was equal, with 50 males and 50 females. MMSE results indicated that 60% of participants scored in the normal range (30–26), whereas 40% demonstrated varying degrees of cognitive impairment, including mild to moderate deficits.
Conclusion: The study identifies a significant cognitive burden among adolescents with JIA, highlighting the importance of integrating cognitive assessment into routine clinical evaluation. Targeted cognitive interventions may improve long-term outcomes and enhance quality of life.
References
Fazaa, A., Sellami, M., Ouenniche, K., Miladi, S., Kassab, S., Chekili, S., Ben Abdelghani, K. & Laatar, A. 2021. Physical Activity Assessment In Children And Adolescents With Juvenile Idiopathic Arthritis Compared With Controls. Archives De Pédiatrie, 28, 47-52.
Granjon, M., Rohmer, O., Doignon-Camus, N., Popa-Roch, M., Pietrement, C. & Gavens, N. 2021. Neuropsychological Functioning and Academic Abilities In Patients With Juvenile Idiopathic Arthritis. Pediatric Rheumatology, 19, 53.
Iversen, M. D., Andre, M. & Von Heideken, J. 2022. Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review Of Randomized Controlled Trials. Pediatric Health Med Ther, 13, 115-143.
Martini, A., Lovell, D. J., Albani, S., Brunner, H. I., Hyrich, K. L., Thompson, S. D. & Ruperto, N. 2022. Juvenile Idiopathic Arthritis. Nature Reviews Disease Primers, 8, 5.
Mena‐Vázquez, N., Cabezudo‐García, P., Ortiz‐Márquez, F., Díaz‐Cordovés Rego, G., Muñoz‐Becerra, L., Manrique‐Arija, S. & Fernández‐Nebro, A. 2021. Evaluation Of Cognitive Function In Adult Patients With Juvenile Idiopathic Arthritis. International Journal Of Rheumatic Diseases, 24, 81-89.
Onel, K. B., Horton, D. B., Lovell, D. J., Shenoi, S., Cuello, C. A., Angeles‐Han, S. T., Becker, M. L., Cron, R. Q., Feldman, B. M. & Ferguson, P. J. 2022. 2021 American College of Rheumatology Guideline for The Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches For Oligoarthritis, Temporomandibular Joint Arthritis, And Systemic Juvenile Idiopathic Arthritis. Arthritis & Rheumatology, 74, 553-569.
Ortiz-Márquez, F., Padilla-Leiva, C., Cabezudo-García, P., Diaz-Cordobes, G., Muñoz-Becerra, L. & Mena-Vázquez, N. 2022. Ab1240 Prospective Evaluation of Cognitive Function In Patients With Juvenile Idiopathic Arthritis. Bmj Publishing Group Ltd.
Paroli, M., Spadea, L., Caccavale, R., Spadea, L., Paroli, M. P. & Nante, N. 2022. The Role of Interleukin-17 In Juvenile Idiopathic Arthritis: From Pathogenesis to Treatment. Medicina, 58, 1552.
Ruperto, N., Brunner, H. I., Synoverska, O., Ting, T. V., Mendoza, C. A., Spindler, A., Vyzhga, Y., Marzan, K., Grebenkina, L. & Tirosh, I. 2021. Tofacitinib In Juvenile Idiopathic Arthritis: A Double-Blind, Placebo-Controlled, Withdrawal Phase 3 Randomised Trial. The Lancet, 398, 1984-1996.
Zhao, W.-J., Deng, J.-H. & Li, C.-F. 2023. Lipid Profiles In Patients With Juvenile Idiopathic Arthritis: A Systematic Literature Review And Meta-Analysis. Lipids In Health and Disease, 22, 136.
Hinze CH, Foell D, Kessel C. Treatment of systemic juvenile idiopathic arthritis. Nat Rev Rheumatol. 2023;19(12):778-89.
Ambler WG, Nanda K, Onel KB, Shenoi S. Refractory systemic onset juvenile idiopathic arthritis: current challenges and future perspectives. Ann Med. 2022;54(1):1839-50.
Weiss JE. Prediction Model for Juvenile Idiopathic Arthritis: Challenges and Opportunities. J Pediatr. 2022; 251:46-9.
Stoustrup P, Resnick CM, Abramowicz S, Pedersen TK, Michelotti A, Küseler A, et al. Management of Orofacial Manifestations of Juvenile Idiopathic Arthritis: Interdisciplinary Consensus-Based Recommendations. Arthritis Rheumatol. 2023;75(1):4-14.
Zaripova LN, Midgley A, Christmas SE, Beresford MW, Baildam EM, Oldershaw RA. Juvenile idiopathic arthritis: from aetiopathogenesis to therapeutic approaches. Pediatr Rheumatol Online J. 2021;19(1):135.
Martini A, Lovell DJ, Albani S, Brunner HI, Hyrich KL, Thompson SD, et al. Juvenile idiopathic arthritis. Nat Rev Dis Primers. 2022;8(1):5.
De Benedetti F, Grom AA, Brogan PA, Bracaglia C, Pardeo M, Marucci G, et al. Efficacy and safety of emapalumab in macrophage activation syndrome. Ann Rheum Dis. 2023;82(6):857-65.
Schmidt C, Ertel T, Arbogast M, Hügle B, Kalle TV, Neff A. The Diagnosis and Treatment of Rheumatoid and Juvenile Idiopathic Arthritis of the Temporomandibular Joint. Dtsch Arztebl Int. 2022;119(4):47-54.
Towe C, Grom AA, Schulert GS. Diagnosis and Management of the Systemic Juvenile Idiopathic Arthritis Patient with Emerging Lung Disease. Paediatr Drugs. 2023;25(6):649-58.
Bansal N, Pasricha C, Kumari P, Jangra S, Kaur R, Singh R. A comprehensive overview of juvenile idiopathic arthritis: From pathophysiology to management. Autoimmun Rev. 2023;22(7):103337.
Huang HYR, Wireko AA, Miteu GD, Khan A, Roy S, Ferreira T, et al. Advancements and progress in juvenile idiopathic arthritis: A Review of pathophysiology and treatment. Medicine (Baltimore). 2024;103(13): e37567.
Onel KB, Horton DB, Lovell DJ, Shenoi S, Cuello CA, Angeles-Han ST, et al. 2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Recommendations for Nonpharmacologic Therapies, Medication Monitoring, Immunizations, and Imaging. Arthritis Care Res (Hoboken). 2022;74(4):505-20.
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Copyright (c) 2025 Samama Abdul Rehman, Mahrukh Warraich, Shabah Surriya, M. Usama Sohail, Muhammad Sohaib Azeem, Khansa Farooq, Tarab Rasool (Author)
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