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Cognitive dysfunction in SLE: development of a screening tool
T Adhikari1, A Piatti, M Luggen
1Division of Immunology, Allergy, and Rheumatology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Background:
Cognitive dysfunction (CD) is among the most common neuropsychiatric manifestations of systemic lupus erythematosus (SLE). There are two methods which have been used to detect CD in patients with SLE: traditional neuropsychological tests (NPT) and the Automated Neuropsychological Assessment Metrics (ANAM). Both are time-consuming and neither is readily available for screening purposes.
Purpose:
The aim of our study was to evaluate the Montreal Cognitive Assessment (MoCA) test as a screening tool for detection of CD in SLE. Methods. SLE patients fulfilling ACR criteria were administered the ANAM, a computerized test battery which measures various cognitive domains and the MoCA, a one-page, performance-based screening test designed to detect mild cognitive impairment in the elderly. With the ANAM as the gold standard, the performance characteristics of the MoCA were assessed.
Results:
In total, 44 patients were evaluated. Of these, 11 (25%) were identified by the ANAM as being impaired in comparison with 13 (29.5%) by the MoCA. The scores were significantly correlated (r = 0.57, p < 0.001). Using the standard cutoff of 26, the sensitivity of MoCA was 83% and specificity 73%.
Conclusion:
The MoCA appears to be a promising screening tool for the detection of CD in SLE both for epidemiologic studies and for routine clinical care.
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