Session Information
Date: Sunday, October 21, 2018
Title: Systemic Lupus Erythematosus – Clinical Poster I: Clinical Manifestations and Comorbidity
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Cognitive impairment (CI) is a common neurobehavioral manifestation of SLE. In our recent systematic review, the prevalence of CI was 38% (95% CI: 33-43%). Studies assessing CI in SLE are mostly cross-sectional and do not provide longitudinal data. Therefore, we aim to report the prevalence of CI and the change over-time in an SLE cohort using a comprehensive battery (CB) of tests.
Methods: Consecutive consenting SLE patients, aged 18-65 years, who attended a single centre (Jul 2016-Apr 2018) were recruited. Patients were administered the CB at baseline (T0), 6 months (T1) and 12 months (T2) which evaluates the following cognitive domains: simple attention and processing speed, visual-spatial construction, verbal fluency, learning and memory (visuospatial and memory), executive functioning (untimed and timed) and manual motor speed and dexterity.
Patient scores were compared to a normative sample of age- and gender-matched healthy controls to obtain z-scores. CI was operationalized on the CB as a z-score of ≤-1.5 (as compared to controls) on ≥2 domains. We determined the status of cognitive function based on the CB at T0, T1 and T2.
Results: Of the 220 patients (89.1% female), the mean age at SLE diagnosis was 28.3 ± 10.5 and disease duration at enrolment was 14.1 ± 10.4 years (Table 1). The prevalence of CI at T0 in 220 patients was 40.9%. Of the 220 patients, 124 had a 6 month follow-up with a CI prevalence of 29.8% and 71 patients had a 12 month follow-up with a CI prevalence of 35.2%.
CI status over 6 months for T0 and T1: Of the 220 patients, 123 had both a T0 and T1 assessment. Sixty-two (50.4%) patients remained non-CI and 30 (24.4%) patients remained CI. Twenty-four (19.5%) patients transitioned from CI to non-CI at T1 and 7 (5.7%) patients transitioned from non-CI to CI at T1.
CI status over 12 months for T0, T1 and T2: Of the 220 patients, 56 patients had 3 assessments at T0, T1 and T2. Of these, 41 (73.2%) patients remained stable across all three time points. Of the 41 patients, 30 patients remained non-CI and 11 patients remained CI over all three time points. Of 56, 15 (26.8%) patients changed CI status from CI to non-CI or vice versa (Table 2).
Conclusion: Cognitive function status in SLE patients fluctuates over time, with 26.8% of patients showing a change in status over a 12-month period. Our results advocate for close monitoring of cognitive function in patients with SLE.
|
Table 1. Cohort characteristics at enrolment (n=220) |
|
|
Characteristic |
Value (N=220) |
|
Gender (Female) |
196 (89.1%) |
|
Ethnicity: Asian Black Caucasian Other |
18 (8.2%) 45 (20.5%) 128 (58.2%) 25 (11.4%) |
|
Age: 18-29 30-39 40-49 50-59 60-69 |
38 (17.3%) 57 (25.9%) 55 (25.0%) 50 (22.7%) 20 (9.1%) |
|
Education: Grade 8 High School College University |
9 (4.2%) 39 (18.4%) 73 (34.4%) 91 (42.9%) |
|
Age at SLE diagnosis (mean ± SD) |
28.3 ± 10.5 |
|
Age at enrolment (mean ± SD) |
42.4 ± 12.1 |
|
Disease duration at enrolment (mean ± SD) |
14.1 ± 10.3 |
|
Table 2. CI status at T0, T1 and T2 (N=56) |
|
|
CI Status |
Frequency (%) |
|
Non-CI at all visits |
30 (53.6) |
|
CI at all visits |
11 (19.6) |
|
Transitioned form non-CI at T0 or T1 to CI at T2 |
6 (10.7) |
|
Transitioned from CI at T0 or T1 to non-CI T2 |
9 (16.1) |
To cite this abstract in AMA style:
Touma Z, Green R, Tartaglia C, Ruttan L, Lombardi S, Anderson N, Su J, Colosimo K, Vitti M, Wither JE, Fritzler MJ, Beaton D. Does Cognitive Function Change over-Time in Systemic Lupus Erythematosus? [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/does-cognitive-function-change-over-time-in-systemic-lupus-erythematosus/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/does-cognitive-function-change-over-time-in-systemic-lupus-erythematosus/