Cognitive dysfunction among people with systemic lupus erythematosus is associated with reduced participation in daily life

Abstract

Objectives This study aimed to investigate the distribution of cognitive function in people with systemic lupus erythematosus (SLE) by objective and self-report measures and associations between cognition and participation among people with SLE. Methods Fifty-five volunteers with SLE (age: 39.7 ± 12.7yrs, female: 92.7%) completed the Montreal Cognitive Assessment (MoCA) to measure cognitive ability objectively, the Cognitive Symptom Inventory (CSI) and PROMIS Cognitive Function 8a (CF) to assess self-reported everyday cognition, and PROMIS-43 Profile to assess self-reported ability to participate in social roles and activities (participation) and other disease-associated symptoms (e.g., depression, pain, fatigue). Results The average MoCA score was 25.3 ± 3.1, with 47.3% of participants scoring <26, which is indicative of cognitive impairment. Group average CSI (35.8 ± 7.9), CF (T-score = 45.0 ± 8.5), and participation (T-score = 46.9 ± 11.2) scores suggest mildly impaired functional cognition and participation compared to normative data. Participation correlated with self-reported everyday cognition measures (r ≥ 0.56, p < 0.01) but not with MoCA (r = 0.25, p = 0.06). In hierarchical linear regression analysis, CSI, fatigue, and pain were each significant independent predictors of participation (R2 = 0.78, p < 0.01). Conclusions We found that cognitive dysfunction is common among people with SLE. Along with pain and fatigue, reduced everyday cognitive function contributes to reduced participation in social, leisure, work, and family-related activities.

Clinical Features and Long-Term Outcomes of Systemic Lupus Erythematosus

“…One of the advantages of PROMIS is that it encompasses a wide variety of domains, despite placing a reduced burden on the patient. As such, PROMIS has been increasingly used in studies to investigate a range of SLE symptoms including pain [51], fatigue [100,101], depression [102], quality of life [103], cognitive impairment [104] and sleep quality [105]. Most notably, some of these symptoms such as cognitive impairment and sleep resonate strongly with SLE patients yet are known to be content gaps in other generic questionnaires [106].…”

Patient-Reported Outcomes for Quality of Life in SLE: Essential in Clinical Trials and Ready for Routine Care

“…One of the advantages of PROMIS is that it encompasses a wide variety of domains, despite placing a reduced burden on the patient. As such, PROMIS has been increasingly used in studies to investigate a range of SLE symptoms including pain [51], fatigue [100,101], depression [102], quality of life [103], cognitive impairment [104] and sleep quality [105]. Most notably, some of these symptoms such as cognitive impairment and sleep resonate strongly with SLE patients yet are known to be content gaps in other generic questionnaires [106].…”

Dynamic changes of amplitude of low-frequency in systemic lupus erythematosus patients with cognitive impairment

“…NPSLE is the second leading cause of death after lupus nephritis in patients with SLE (Schwartz et al, 2019), and the mortality rate is 10 times higher than that of the general population (Zirkzee et al, 2014), and it severely damaged the patients' quality of life (Ogunsanya et al, 2018). The prevalence of CI in patients with SLE reported in previous studies was highly heterogeneous, ranging from 6.6 to 80.0% (Schwartz et al, 2019), significantly higher than in healthy individuals (Kozora et al, 1996;Al-Homood et al, 2017;Zhang et al, 2017;Shaban and Leira, 2019;Kim et al, 2021). Identifying and assessing SLE-related CI remains challenging at present due to the lack of sensitive and standardized neuropsychiatric tests and diagnostic biomarkers (Seet et al, 2021).…”