Association of depression and cognitive functioning in patients with systemic lupus erythematosus (SLE) in a metropolitan Atlanta cohort Öffentlichkeit
Shan, Holly (Spring 2021)
Published
Abstract
Significance: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with health consequences that can be debilitating for patients, regardless of gender or age. Cognitive dysfunction is a common obstacle for patients with SLE but is often ignored in a clinical setting. Preliminary studies have found depression is associated with such symptoms; however, few studies explore the association between depression and SLE-induced cognitive functions. Insights from such studies serve to improve and expand the quality of care for SLE.
Objective: To examine whether there are associations between depression and performance on cognitive tests measuring episodic memory, working memory, processing speed, attention, inhibition control, and cognitive flexibility in a cohort of patients from metropolitan Atlanta with SLE.
Participants: 50 participants with SLE were recruited from the Georgians Organized Against Lupus (GOAL) cohort (Mean age: 49.0 ± 12.4).
Measures: Depression was measured with the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire; both t-scores and dichotomized scores (no vs. any symptoms of depression) were used. Cognitive performance was measured at the same visit using the NIH Toolbox Fluid Cognition Battery, CLOX Drawing task, and Trail Making B task.
Results: No statistically significant associations were found between PROMIS depression scores and any of the cognitive function measures. There were slight associations between higher PROMIS depression scores and worse performance on cognitive tests (Pearson’s r correlation coefficients were all negative and had magnitudes <0.1; Linear regression beta coefficients were all negative and had magnitudes <2). All participants with any depressive symptoms had lower scores on all but one cognitive function test compared to participants with no depressive symptoms.
Conclusions: In this cohort of SLE patients, depression was not associated with cognitive function. This may indicate that other factors play a role in cognitive decline in the setting of SLE.
Table of Contents
Table of Contents
Abstract 1
Introduction and Background 6
Epidemiology of SLE 7
Depression and Cognitive Impairment in SLE 8
Cognitive Impairments Specific to SLE 10
Purpose of Study 12
Hypothesis 13
Methods and Materials 13
Study Variables 15
Statistical Analysis 17
Results 18
Discussion 20
Tables and Figures 26
Table 1. Additive criteria for SLE diagnosis by the European League Against Rheumatism and American College of Rheumatology 26
Table 2. Neuropsychiatric symptoms in SLE (American College of Rheumatology, 1999) 27
Table 3. Demographic Summary of Study Participants (n = 50) 28
Table 4. Pearson’s r Correlations between Cognitive Function Measures and PROMIS Depression T Scores. 29
Table 5. Linear Regressions of Crude Associations of Cognitive Function Measures per 10 units of PROMIS Depression T scores 30
Table 6. Results of T-Test of Cognitive Function Measures and PROMIS Depression T Scores of patients with depressive symptoms and patients without depressive symptoms 31
Figure 1. Distribution of PROMIS Depression T Scores 32
Figure 2. Picture Sequence Memory vs. Depression 33
Figure 3. Flanker Inhibitory Control vs. Depression 34
Figure 4. Dimensional Change Card Sort vs. Depression 35
Figure 5. List Sorting Working Memory vs. Depression 36
Figure 6. Pattern Comparison Processing Speed vs. Depression 37
Figure 7. CLOX Score vs. Depression 38
Figure 8. Trail B Making Time vs. Depression 39
Works Cited 40
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