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Neuropsychologic functioning and health status in systemic lupus erythematosus: does ethnicity matter?
Nicholas A Doninger1, Joseph W Fink, Tammy O Utset
1Department of Internal Medicine, The Wallace-Kettering Neuroscience Institute, Kettering Medical Center Network, Kettering, Ohio 45429, USA. nicholas.doninger@kmcnetwork.org
Background:
Despite increased severity of lupus in blacks, including more frequent neuropsychiatric manifestations, there is sparse data on neuropsychologic function in black patients with lupus.
Methods:
Neuropsychologic functioning and health-related variables were examined among blacks (n = 34) and whites (n = 14) fulfilling American College of Rheumatology criteria for systemic lupus erythematosus.
Results:
Blacks and whites performed comparably on measures of verbal and visual memory, working memory, and motor speed after controlling for estimates of premorbid cognitive ability. Blacks trended towards poorer performance on specific attention/processing speed measures. Pain, fatigue, depression, anxiety, physical and emotional well-being were unrelated to ethnicity. Blacks exhibited a trend towards greater impairment of physical functioning. Ethnicity-related differences in overall damage, noncognitive neuropsychiatric manifestations, and prevalence of nephritis revealed greater severity among blacks.
Conclusions:
Initial differences in premorbid cognitive function possibly contribute to disparate clinical outcomes, including a greater proportion of blacks exhibiting subnormal neurocognitive performance. Blacks evidencing lower premorbid ability may be at greater vulnerability for poorer functional outcomes (eg, coping skills, medical compliance and employment) if they experience disease-related cognitive dysfunction.
