People mostly associate RA with swollen and painful joints. However, for many people with RA that is only one of the symptoms they face.
RA is a chronic condition that causes inflammation throughout the body. This inflammation can lead to joint pain and stiffness, swelling, and decreased joint mobility. RA can also affect the eyes, skin, lungs, and brain.
Many people with RA and other chronic inflammatory conditions also complain of feeling mentally foggy and having difficulty thinking.
Scientists believe there may be a link between chronic inflammation and the cognitive impairment that people refer to as brain fog.
A 2018 study published in Nature Communications looked at how chronic inflammation might affect the brain. They used MRI scanners to take images of the brains of 54 people with RA.
The results showed a link between RA inflammation and changes in the patterns of brain connections. It also showed a lower volume of gray matter in an area of the brain known as the inferior parietal lobe.
The study suggests that fatigue, pain, and an impaired ability to think are associated with these brain changes.
Researchers believe these alterations to brain tissues may have a role in converting inflammation signals to the rest of the central nervous system.
A larger study from 2013 looked at 115 people with RA. This research also found that RA is related to an impaired ability to think.
The results suggest that the risk is higher in people who use corticosteroids as an RA treatment and who have risk factors for heart disease, which may include high blood pressure or high cholesterol.
Lastly, people living with chronic pain may find themselves distracted by the pain, and the fatigue the pain causes. Not only does pain pull a person’s focus away from mental tasks, but it may disrupt the amount or quality of sleep they get, leading to tiredness.
People who sleep poorly often report feelings of being not as alert or feeling foggy.
Other effects of RA on the brain
Many people with RA and other chronic pain conditions experience depression or anxiety. Depression and anxiety may also cause brain fog and an impaired ability to think straight.
Similarly, depression can cause restlessness, insomnia, and other symptoms that may lead to decreased mental abilities.
Other causes of brain fog
Stress and lack of sleep can also cause brain fog.
Many other factors and conditions can cause brain fog in addition to RA. These can include inflammatory or other medical conditions, mood disorders, and lifestyle factors.
The following conditions of lifestyle factors can all cause brain fog:
- Sjogren’s syndrome
- multiple sclerosis (MS)
- lupus
- fibromyalgia
- thyroid problems, such as hypothyroidism or Hashimoto’s disease
- chronic fatigue syndrome (CFS)
- anemia
- depression
- pregnancy
- menopause
- chemotherapy
- antidepressants
- stress
- lack of sleep
- lack of exercise
Treating and preventing brain fog
Making lists and using a planner will help with organization.
Brain fog can be very frustrating for those living with RA. There are steps a person with RA can take to help treat and alleviate brain fog.
Treatment and lifestyle modifications to help manage brain fog associated with RA include:
- disease-modifying anti-rheumatic drugs known as DMARDs
- biologic drugs that block inflammation and relieve pain
- getting more sleep
- exercising regularly
- staying organized by using a set schedule, a planner with key events, and to-do lists
Outlook
RA causes chronic inflammation. Along with its effects on the joints, RA may cause brain fog, which can involve difficulty concentrating, poor memory, or confused thoughts.
RA is a degenerative condition, meaning it tends to worsen over time, and with age if people do not treat it correctly. However, treatments are available to prevent or slow the progression of RA and manage the symptoms.
With treatment and lifestyle modification, a person with RA can manage and limit brain fog.
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