Increased Risk of Dementia in Patients With Systemic Lupus Erythematosus: A Nationwide Population‐Based Cohort Study

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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“…A cohort and cross‐sectional study demonstrated RA patients are at higher risk of developing dementia but there is high statistical heterogeneity and no causality in it . A population‐based cohort study found that the risk of developing dementia in patients with systemic lupus erythematosus (SLE) is two times higher than patients without SLE . Studies showed that SLE may lead to the destruction of central nervous system and vascular lesions due to antiphospholipid antibodies and drug use, which leads to dementia …”

Section: Introductionmentioning

confidence: 99%

“…5 A population-based cohort study found that the risk of developing dementia in patients with systemic lupus erythematosus (SLE) is two times higher than patients without SLE. 8 Studies showed that SLE may lead to the destruction of central nervous system and vascular lesions due to antiphospholipid antibodies and drug use, which leads to dementia. [9][10][11][12] However, there is no large epidemiologic study to demonstrate the relationship between dementia and rheumatic diseases.…”

Section: Introductionmentioning

confidence: 99%

Rheumatic diseases are associated with a higher risk of dementia: A nation‐wide, population‐based, case‐control study

Chen

Fan

et al. 2017

Int J of Rheum Dis

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“…These include MS, [104][105][106] sarcoidosis, [107][108][109] primary angiitis of the CNS, [110][111][112] amyloid β-related angiitis, 113 Susac's syndrome, 114,115 Rasmussen's encephalitis and other inflammatory epilepsies, 116,117 and systemic rheumatologic conditions. [118][119][120][121][122][123][124] Diagnosing Autoimmune Dementia…”

Section: Aid-ae In Patients With Other (Atypical) Causes Of Aementioning

confidence: 99%

Autoimmune Dementia

Long

Day

2018

Semin Neurol

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Dementia refers to an acquired syndrome of intraindividual cognitive decline that ultimately interferes with an individual's ability to manage their usual duties at work or home. As experience with the diagnosis and management of patients with autoimmune and paraneoplastic encephalitis (AE) has expanded, it has become increasingly apparent that dementia may arise as a subacute or chronic complication of immune-mediated injury to the central nervous system. Progressive memory and thinking problems may represent the first (or only) sign of an underlying autoimmune or paraneoplastic disease. Accordingly, there is a need to routinely consider the diagnosis of AE in patients with dementia, and to evaluate patients recovering from AE for clinically meaningful cognitive impairment. We review and summarize the available evidence concerning the diagnosis and care of AE patients with associated cognitive impairment, herein referred to as autoimmune dementia (AiD). Relevant information is used to propose a novel diagnostic framework that may be applied to improve recognition, and facilitate the expedited evaluation and treatment of patients with AiD.

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Increased Risk of Dementia in Patients With Systemic Lupus Erythematosus: A Nationwide Population‐Based Cohort Study

Abstract: Patients with SLE have a higher risk of dementia.

Cited by 25 publications

References 29 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

Rheumatic diseases are associated with a higher risk of dementia: A nation‐wide, population‐based, case‐control study

Autoimmune Dementia

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