Screening for cognitive impairment in systemic lupus erythematosus

Area of Science:

• Neuropsychology
• Rheumatology
• Psychiatry

Background:

• Systemic lupus erythematosus (SLE) is associated with cognitive dysfunction.
• Screening questionnaires are used to assess cognitive symptoms, but their validity in SLE needs evaluation.
• Objective cognitive testing provides performance metrics, but its correlation with self-reported symptoms is not fully understood.

Purpose of the Study:

• To examine the association between self-reported cognitive symptoms (Cognitive Symptom Inventory - CSI) and objective cognitive performance (Automated Neuropsychological Assessment Metrics - ANAM) in patients with SLE.
• To compare CSI responses between patients with SLE and rheumatoid arthritis (RA).
• To determine if anxiety and depression influence cognitive symptom reporting in SLE.

Main Methods:

• Compared CSI and Hospital Anxiety and Depression Scales (HADS) in SLE and RA patients.
• Assessed cognitive performance in SLE patients using ANAM, measuring efficiency via throughput and inverse efficiency.
• Used linear regression to analyze associations between CSI scores and ANAM performance, adjusting for relevant covariates.

Main Results:

• Patients with SLE reported higher CSI scores, particularly for attention/concentration, compared to RA patients.
• In SLE patients, CSI scores positively correlated with neuropsychiatric events, anxiety, and depression.
• After adjusting for covariates, no significant association was found between CSI scores and ANAM cognitive performance in SLE patients.

Conclusions:

• The CSI is not a reliable tool for screening cognitive processing efficiency in SLE.
• Cognitive complaints reported via the CSI in SLE patients are significantly influenced by comorbid anxiety and depression.
• Further research should explore the interplay between psychological factors and cognitive symptoms in SLE.