Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus

Abstract

Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (>18 years) SLE patients, we examined the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms: forgetfulness [severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire] and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). We used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID=0.5*SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR=1.43, 95% CI 1.29–1.47) and difficulty concentrating (OR=2.19, 95% CI 1.90–2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.

The Perceived Stress Scale-10 (PSS-10) is reliable and has construct validity in Chinese patients with systemic lupus erythematosus

“…Stress has become a risk factor in patients with SLE; it can lead to depression, functional disability, cognitive impairment, and finally adversely affect the quality of life. [33][34][35] Therefore, assessment of perceived stress is valuable in determining the extent of the emotional and physical well-being of patients with SLE. To some extent, perceived stress depends on the individual's perception of stressfulness and the ability to cope with stressors.…”

Perceived Stress and Associated Factors in Russian Medical and Dental Students: A Cross-Sectional Study in North-West Russia

“…Nevertheless, information on the clinical implications of differences in PSS scores is limited. We found only one study that analyzed PSS-10 scores in terms of MCID, estimated as 4.03 points and calculated as one half of SD, in patients with systemic lupus erythematosus [14].…”

Cognitive Reserve and Social Capital Accrued in Early and Midlife Moderate the Relation of Psychological Stress to Cognitive Performance in Old Age

“…In particular, both physiological and psychological stress have been found to impair several domains of cognitive functioning (e.g., memory, processing speed, and executive functioning) throughout the life course [28-35]. Yet, the relationship between stress and cognitive performance is not always strictly linear and negative since it also depends on the particular stress exposure (short or long term, intensity, etc.)…”