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2 results

  • Cognitive Impairment in Patients with Ankylosing Spondylitis

  • Bruno Kusznir Vitturi, Enrico Stefano Suriano, Ana Beatriz Pereira de Sousa, Dawton Yukito Torigoe
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 47 / Issue 2 / March 2020
    Published online by Cambridge University Press:
    13 January 2020, pp. 219-225
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  • Background:

    Little is known about the potential systemic effects of ankylosing spondylitis (AS) on the nervous system. We designed a study aiming to assess the frequency and clinical predictors of cognitive impairment in AS patients.

    Methods:

    We carried out a cross-sectional case–control study composed of consecutive patients with AS. Trained and blinded interviewers registered clinical-epidemiological data and applied a standardized neurological assessment for each subject of the study. At baseline, functional limitations were characterized using the Health Assessment Questionnaire. Cognitive impairment was evaluated with the Brief Cognitive Screening Battery, the Montreal Cognitive Assessment, and the Clinical Dementia Rating, while neuropsychiatric symptoms were investigated with the Hospital Anxiety and Depression Scale. Healthy controls were matched for age, educational attainment, sex, and comorbidities. We compared the neurological outcomes between case and controls, and we determined the clinical predictors of cognitive decline.

    Results:

    We included 40 patients (mean: 49.3 years) with AS and 40 healthy controls (mean: 48.8 years) in our study. In Brief Cognitive Screening Battery, patients with AS presented a statistically significant poor performance in the clock drawing test and in the verbal fluency. The mean Montreal Cognitive Assessment (MoCA) scores were significantly lower in AS subjects compared to the control group. Also, the prevalence of subjects classified as cognitively impaired according to MoCA was significantly higher in the AS group (90.0% vs. 57.5%, p = 0.02). Moreover, neuropsychiatric symptoms were more prevalent in AS patients. Worse functional limitations were associated with poor cognitive performance as well.

    Conclusions:

    Patients with AS might be more vulnerable to cognitive decline.

  • SOCIOECONOMIC COSTS OF RHEUMATIC DISEASES: Implications for Technology Assessment

  • Dick Jonsson, Magnus Husberg
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 16 / Issue 04 / October 2000
    Published online by Cambridge University Press:
    25 May 2001, pp. 1193-1200

  • Objectives: To study the socioeconomic impact of rheumatic illness in Sweden and to discuss the consequences for technology assessment studies.

    Methods: A cost-of-illness study based on data from official statistics and treatment studies.

    Results: The total socioeconomic cost was 52 billion Swedish kronor (SEK) in 1994. The imbalance between direct (10% of total) and indirect costs (90effectiveness of the healthcare sector, the need for new treatment methods, appropriate information systems, and technology assessment studies as well as the institutional arrangements for rehabilitation and basic medical research.

    Conclusions: A discussion of solutions for financial cooperation between county councils and regional social insurance offices should be considered. The new biotechnological pharmaceuticals will increase the cost for drugs in health care about 20 times, but the total socioeconomic cost for society may remain at the same level due to a decrease of inpatient costs and indirect costs for loss of production as well as a decrease of transfer payments from social insurance. It is unavoidable that the new pharmaceuticals require priority discussions and active resource allocation in health care and in other sectors of society.