ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 0895

Insight into Intraindividual Variability Across Neuropsychological Tests and Its Association with Cognitive Dysfunction in Patients with Systemic Lupus Erythematosus

Jennifer He1, Juan Diaz-Martinez2, Kathleen Bingham3, Jiandong Su4, Mahta Kakvan4, Maria Tartaglia4, Lesley Ruttan3, Dorcas Beaton5, Joan Wither4, May Choi6, Marvin Fritzler7, Nicole Anderson4, Dennisse Bonilla4, Robin Green4, Patricia Katz8 and Zahi Touma9, 1Western University, London, ON, Canada, 2UHN, Toronto, ON, Canada, 3University of Toronto, University Health Network, Toronto, ON, Canada, 4University Health Network, Toronto, ON, Canada, 5Institute for Work & Health, Toronto, ON, Canada, 6Brigham and Women's Hospital | University of Calgary, Calgary, AB, Canada, 7University of Calgary, Calgary, AB, Canada, 8University of California San Francisco, San Francisco, CA, 9University of Toronto, Mississauga, ON, Canada

Meeting: ACR Convergence 2021

Keywords: ,

Session Information

Date: Sunday, November 7, 2021

Title: SLE – Diagnosis, Manifestations, & Outcomes Poster II: Manifestations (0855–0896)

Session Type: Poster Session B

Session Time: 8:30AM-10:30AM

Background/Purpose: Dispersion is defined as the variability in an individual’s performance across multiple tasks at a single assessment visit. This measure has been studied in a number of neurodegenerative and neurodevelopmental disorders, in which increased dispersion was generally found to be associated with cognitive dysfunction (CD). We aim to compute a dispersion score using the tests of the American College of Rheumatology Neuropsychological battery (ACR-NB) and to determine the association between this dispersion score and the risk of CD in SLE patients.

Methods: This retrospective longitudinal study included patients who attended the Lupus Clinic from January 2016 to October 2019. A total of 301 adult SLE patients were administered the ACR-NB at their initial visit, 6 months and 12 months. CD was defined as a z-score of ≤-1.5 on ≥2 domains or z ≤-2 on ≥1 domain. The 19 tests of the ACR-NB were used to compute a type of dispersion score, the intraindividual standard deviation (ISD). To obtain the ISD, the standard deviation of the age- and sex- adjusted z-scores was calculated for each visit, resulting in a maximum of 3 scores per patient. To estimate the association between ISD and patient’s cognitive status (CD and non-CD), we used multi-level logistic regression, adjusting for clinically important covariates.

Results: CD was observed in 106 patients (35.2%) at baseline, 52 patients (27.8%) at 6 months, and 53 patients (28.0%) at 12 months. Among all observations across 3 visits, the mean age- and sex-adjusted ISD was 1.40 ± 0.55. Prior to adjustment for covariates, the mean ISD for the non-CD group was 1.10 ± 0.31 compared with 1.50 ± 0.70 for the CD group. After adjusting for ethnicity, education, employment, socioeconomic status and anxiety/depression, there was a statistically significant association between ISD and cognitive status (odds ratio [OR] for one unit increase in ISD: 13.56, 95% CI: 4.80-38.31; OR for 1/10th unit increase in ISD: 1.30, 95% CI: 1.17-1.44). Findings were robust to multiple sensitivity analyses. Multivariable random intercept logistic regression modelling is provided in Table 1. ISD scores across 3 assessment visits for non-CD and CD patients is provided in Figure 1.

Conclusion: Dispersion scores such as ISD have been explored as a pragmatic and sensitive marker of cognitive function in different patient populations. We showed that among adult SLE patients, increased ISD across the cognitive tests of the ACR-NB was associated with an increased likelihood of having CD, adjusting for important covariates. Additional research is warranted to evaluate the promise of dispersion scores in clinical practice.

Figure 1. Intraindividual standard deviation (ISD) scores across three assessment visits for non-CD patients and CD patients.

Table 1. Multivariable random intercept logistic regression model

Disclosures: J. He, None; J. Diaz-Martinez, None; K. Bingham, None; J. Su, None; M. Kakvan, None; M. Tartaglia, None; L. Ruttan, None; D. Beaton, None; J. Wither, None; M. Choi, MitogenDx, 1, 2; M. Fritzler, Inova Diagnostics Inc., 2, 6, Werfen International, 2, Alexion Canada, 6, Mitogen Diagnostics Corp., 3, 8, 9, 10; N. Anderson, None; D. Bonilla, None; R. Green, None; P. Katz, None; Z. Touma, AbbVie Inc, 2, UCB Biopharma SRL, 2, Sarkana Pharma Inc., 1, 4, Janssen Inc., 2, GlaxoSmithKline Inc., 6.

To cite this abstract in AMA style:

He J, Diaz-Martinez J, Bingham K, Su J, Kakvan M, Tartaglia M, Ruttan L, Beaton D, Wither J, Choi M, Fritzler M, Anderson N, Bonilla D, Green R, Katz P, Touma Z. Insight into Intraindividual Variability Across Neuropsychological Tests and Its Association with Cognitive Dysfunction in Patients with Systemic Lupus Erythematosus [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/insight-into-intraindividual-variability-across-neuropsychological-tests-and-its-association-with-cognitive-dysfunction-in-patients-with-systemic-lupus-erythematosus/. Accessed .

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