High proportions of dementia among <scp>SLE</scp> patients: A big data analysis

Background: Since the introduction of glucocorticoids (GCs) in the physician’s pharmacological arsenal, it has been known that they are a cause of behavioral or psychiatric adverse events (BPAE), as well as of cognitive problems. To the best of our knowledge, the relationship between these adverse events and GCs in older persons has never been evaluated, except through case-reports or series with few cases. In this paper, a review of the literature regarding BPAEs and cognitive disorders in older people treated with CSs is undertaken. Methods: A comprehensive literature search for BPAEs was carried out on the three main bibliographic databases: EMBASE, MEDLINE and PsycINFO (NICE HDAS interface). Emtree terms were: Steroid, steroid therapy, mental disease, mania, delirium, agitation, depression, behavior change, dementia, major cognitive impairment, elderly. The search was restricted to all clinical studies and case reports with focus on the aged (65+ years) published in any language since 1998. Results: Data on the prevalence of the various BPAEs in older patients treated with GCs were very scarse, consisting mainly of case reports and of series with small numbers of patients. It was hence not possible to perform any statistical evaluation of the data (including meta-analysis). Amongst BPAEs, he possibility that delirium can be induced by GCs has been recently been questioned. Co-morbidities and polypharmacy were additional risk factors for BPAEs in older persons. Conclusions: Data on BPAEs in older persons treated with GCs, have several unmet needs that need to be further evaluated with appropriately designed studies.

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“…In fact, some of these conditions can, in their selves, induce a cognitive impairment. An example of this is SLE [ 63 , 64 ].…”

Section: Resultsmentioning

confidence: 99%

Behavioral, Psychiatric, and Cognitive Adverse Events in Older Persons Treated with Glucocorticoids

Manzo¹,

Serra-Mestres

Castagna³

et al. 2018

Medicines

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“…SLE affects nervous system inducing neuropsychiatric disorders (neuropsychiatric SLE, NPSLE). 5,[27][28][29][30][31][32][33] Mood disorders, and especially depression, are considered to be one of the most prevalent neuropsychiatric comorbidities in SLE. 5,34 Our study results support the aforementioned even though a considerable number of the mild cases are treated in the primary health care and never reach specialized care.…”

Section: Discussionmentioning

confidence: 99%

Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

Kariniemi

Rantalaiho

Virta

et al. 2020

Lupus

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The objective of the study was to examine the risk of other morbidities among patients with systemic lupus erythematosus (SLE). A total of 1006 adult new-onset SLE patients were identified during 1.1.2000- 31.12.2014 from the register of Social Insurance Institution. For each case three general population controls matched according to age, sex and place of residence at the index day were sampled from the population register. Both groups were followed up from the index date until the end of 2017 or until death. The national register on specialized care was explored to gather broadly their 12 organ-specific morbidities, which were found among 91.2% of SLE patients and 66.7% of comparators. The rate ratio (RR) was elevated in almost all disease groups. Musculoskeletal, cardiovascular and genitourinary conditions were the most common comorbidities with RRs of 1.82 (1.68 to 1.97), 1.91 (1.76 to 2.08) and 1.91 (1.73 to 2.09), respectively. Men with SLE had a significantly higher risk for diseases of the genitourinary system and endocrine, nutritional and metabolic diseases compared to women with SLE. The risk of concurrent morbidities is essential to note in the care of SLE patients.

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“…There is a link between Cerebral inflammation and degeneration in systemic lupus erythematosus [44], but inverse relations suggested for SLE and parkinsons disease patients since SLE had a decreased risk of subsequent Parkinson disease [45]. However, study indicates that the risk of dementia may be elevated in individuals with SLE, an autoimmune disease affecting a range of systems including the peripheral and central nervous system concluding SLE is significantly associated with dementia [46]. WDR1: WDR1 is associated with adaptive immunity highlighting its central role immunologic synapses [47] and cardiovascular diseases [48] [47].…”

Section: Discussionmentioning

confidence: 99%

Identification of common molecular biomarker signatures in blood and brain of Alzheimer’s disease

Rahman¹,

Islam

Shahjaman

et al. 2018

Preprint

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Background: Alzheimers disease (AD) is a progressive neurodegenerative disease characterized by memory loss and confusion. Neuroimaging and cerebrospinal fluid-based early detection is limited in sensitivity and specificity as well as by cost. Therefore, detecting AD from blood cell analysis could improve early diagnosis and treatment of the disease. The present study aimed to identify blood cell transcripts that reflect brain expression levels of factors linked to AD progression. Methods: We analyzed blood cell and brain microarray gene expression datasets from NCBI-GEO for AD association and expression in blood and brain. We also used eQTL and epigenetics data to identify AD-related genes that were regulated similarly in blood and brain. Results: We identified 9 differentially expressed genes (DEG; AD versus controls) common to blood cells and brain (CNBD1, SUCLG2-AS1, CCDC65, PDE4D, MTMR1, C3, SLC6A15, LINC01806, and FRG1JP) and 18 genes (HSD17B1, GAS5, RPS5, VKORC1, GLE1, WDR1, RPL12, MORN1, RAD52, SDR39U1, NPHP4, MT1E, SORD, LINC00638, MCM3AP-AS1, GSDMD, RPS9, and GNL2) that were commonly dysregulated between AD blood and brain tissues using SNP and cis-eQTL data. This data revealed significant neurodegeneration-associated molecular pathways in the ribosomal and complement systems. Integration of these different analyses revealed dysregulation of hub transcription factors (SREBF2, NR1H2, NR1H3, PRDM1, XBP1) and microRNAs (miR-518e, miR-518a-3p, miR-518b, miR-518c, miR-518d-3p and miR-518f) in AD. Several significant histone modification sites in DEGs were also identified. Conclusion: We have identified new putative links between pathological processes in brain and transcripts in blood cells in AD subjects that may enable the use of blood to diagnose and monitor AD onset and progression.

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High proportions of dementia among SLE patients: A big data analysis

Abstract: Systemic lupus erythematosus is significantly associated with dementia. This finding should give rise to search for SLE in patients with an ambiguous cause for dementia, especially those with an early onset cognitive decline.

Cited by 17 publications

References 41 publications

Behavioral, Psychiatric, and Cognitive Adverse Events in Older Persons Treated with Glucocorticoids

Behavioral, Psychiatric, and Cognitive Adverse Events in Older Persons Treated with Glucocorticoids

Multimorbidity among incident Finnish systemic lupus erythematosus patients during 2000–2017

Identification of common molecular biomarker signatures in blood and brain of Alzheimer’s disease

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