ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 1621

Prevalence of Cognitive Impairment in Systemic Lupus Erythematosus Assessed By the Automated Neuropsychological Assessment Metrics

Zahi Touma1, Robin Green2, Lesley Ruttan3, Sabrina Lombardi3, Carmela Tartaglia4, Nicole Anderson5, Jiandong Su6, Kenneth Colosimo6, Michelle Vitti6, Dennisse Bonilla6, Joan E. Wither5, Marvin J. Fritzler7 and Dorcas Beaton8, 1Rheumatology, University of Toronto, Division of Rheumatology, Institute of Health Policy, Management and Evaluation, Toronto, ON, Canada, 2Brain and Therapeutics, Toronto Rehabilitation Institute, Toronto, ON, Canada, 3Toronto Rehabilitation Institute, Toronto, ON, Canada, 4University of Toronto, Krembil Neurosciences Centre, Toronto, ON, Canada, 5Rheumatology, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 6University of Toronto, Toronto Western Hospital, Toronto, ON, Canada, 7Medicine, University of Calgary, Calgary, AB, Canada, 8Mobility Program Clinical Research Unit, St Michael's Hospital, Toronto, ON, Canada

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Assessment, Cognitive dysfunction and systemic lupus erythematosus (SLE)

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 6, 2017

Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment Poster II: Damage and Comorbidities

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The screening and diagnosis of Cognitive Impairment (CI) in Systemic Lupus Erythematosus (SLE) patients is often delayed. CI diagnosed according to the American College of Rheumatology (ACR)-SLE battery is associated with a remarkable administrative and cost burden. The Automated Neuropsychological Assessment Metrics (ANAM) is a promising computerized battery of tests that is easy to administer. In our recent systematic review, we found a CI prevalence of 34% by ANAM (95% CI: 25-44%) and by the comprehensive batteries 38% (95% CI: 33-43%). We aimed to determine the prevalence of CI based on the ANAM (v4) GNS Battery using different definitions for CI.

 

Methods: Consecutive SLE patients, aged 18-65 years, who attended the University of Toronto Lupus Clinic between July 2016 and April 2017 and agreeing to participate were included.  Patients were administered the ANAM (v4) GNS, which consists of 15 subtests that evaluate key neurocognitive domains (processing speed, attention, memory, visuospatial processing, and executive functioning). ANAM throughput scores were used to provide an estimate of ‘cognitive efficiency’. Patient scores were compared to a normative sample of age and gender-matched healthy controls to obtain z-scores. Cognitive impairment was operationalized on the ANAM as a z-score of ≤ -1.5 (as compared to controls) on ≥ 2 subtests, or ≤-2.0 on ≥1 subtests. The finger tapping subtest scores for both dominant and non-dominant hands were averaged to calculate a single subtest z-score. The two subtests for simple reaction times were also averaged to calculate a single summary z-score for both tests.   Descriptive statistics were used.

 

Results: Of the 105 patients, 90.6% female, 45.6% were Caucasian, 16.7% Blacks, 5.3% Asians and 32.6% others. The mean age at SLE diagnosis was 28.0 ± 10.0 and lupus duration at enrolment was 16.3 ± 10.0 years.

Thirty-eight (35.5%) patients had CI based on z ≤-1.5 on ≥ 2 subtests and 43 (40.2%) patients based on ≤-2.0 on ≥1 subtests (Table 1).   The prevalence of CI in each of the 15 subtests varied from 3.8-26.4% (z ≤-1.5) and 0.9-17.0% (z ≤-2.0) (Table 2).  

 

Conclusion: A high prevalence of CI, varying between 35.5-40.2% (z≤-1.5 in ≥2 subtests and z≤-2.0 in ≥1 subtests respectively) was identified by the ANAM in this cohort of young SLE patients. The CI prevalence of 35.5-40.2% is similar to the reported prevalence with ANAM and the comprehensive batteries found in SLE literature. Future studies should address the validity of ANAM (v4) GNS Battery against ACR-SLE battery.

 

 

Table 1. Frequency of SLE patients with throughput z-scores of ≤-1.5 and ≤-2.0 (N=107)

Number of Subtests

No. (%) of Patients that scored z ≤-1.5

No. (%) of Patients that scored z ≤-2.0

0

47 (43.9%)

64 (59.8%)

≥1

60 (56.1%)

43 (40.2%)

≥2

38 (35.5%)

20 (18.7%)

≥3

28 (26.1%)

12 (11.2%)

≥4

23 (21.5%)

8 (7.5%)

≥5

17 (15.9%)

8 (7.5%)

≥6

12 (11.2%)

8 (7.5%)

≥7

7 (6.5%)

2 (1.9%)

≥8

6 (5.6%)

0 (0.0%)

≥9

5 (4.8%)

0 (0.0%)

≥12

2 (1.9%)

0 (0.0%)

Number of patients with z-scores ≤-1.5 overlap with patients with z-scores ≤-2

 

 

Table 2. Prevalence of patients with throughput z-scores of ≤-1.5 and ≤-2.0 (N=107)

Performance Test

No. (%) of Patients that scored z ≤-1.5

No. (%) of Patients that scored z ≤-2.0

Simple Reaction Time

23 (21.5%)

16 (15.0%)

Code Substitution – Learning

9 (8.4%)

2 (1.9%)

Procedural Reaction Time

18 (16.8%)

8 (7.5%)

Mathematical Processing

14 (13.2%)

5 (4.7%)

Matching to Sample

20 (18.7%)

7 (6.5%)

Code Substitution – Delayed

20 (18.7%)

4 (3.7%)

Simple Reaction Time (R)

28 (26.4%)

18 (17.0%)

Go/No-Go

4 (3.8%)

1 (0.9%)

Logical Relations

21 (19.8%)

10 (9.4%)

Spatial Processing

16 (15.1%)

8 (7.5%)

Tower Puzzle

7 (6.7%)

3 (2.9%)

Tapping – Right Hand

8 (7.9%)

5 (5.0%)

Tapping – Left Hand

8 (8.1%)

3 (3.0%)

2-Choice Reaction Time

20 (19.0%)

10 (9.5%)

Running Memory CPT

19 (18.1%)

12 (11.4%)

Number of patients with z-scores ≤-1.5 include patients with z-scores ≤-2

 


Disclosure: Z. Touma, None; R. Green, None; L. Ruttan, None; S. Lombardi, None; C. Tartaglia, None; N. Anderson, None; J. Su, None; K. Colosimo, None; M. Vitti, None; D. Bonilla, None; J. E. Wither, None; M. J. Fritzler, Inova Diagnostics, Inc., 5; D. Beaton, None.

To cite this abstract in AMA style:

Touma Z, Green R, Ruttan L, Lombardi S, Tartaglia C, Anderson N, Su J, Colosimo K, Vitti M, Bonilla D, Wither JE, Fritzler MJ, Beaton D. Prevalence of Cognitive Impairment in Systemic Lupus Erythematosus Assessed By the Automated Neuropsychological Assessment Metrics [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/prevalence-of-cognitive-impairment-in-systemic-lupus-erythematosus-assessed-by-the-automated-neuropsychological-assessment-metrics/. Accessed .
  • Tweet
  • Email
  • Print

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-cognitive-impairment-in-systemic-lupus-erythematosus-assessed-by-the-automated-neuropsychological-assessment-metrics/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology