Lupus Linked to Cognitive Dysfunction - EMJ

Lupus Linked to Cognitive Dysfunction

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A RECENT study has revealed that patients diagnosed with systemic lupus erythematosus (SLE) exhibit lower levels of fluid cognition, the ability to reason and solve new problems, than the national average. This is particularly evident in the domains of attention and inhibitory control.  

Led by Laura C. Plantinga, University of California, San Francisco, USA, the study recruited 199 adults (mean age: 46.1 years) with SLE from the metropolitan Atlanta area between October 2019–May 2022. Participants underwent in-person fluid cognition assessments using the NIH Toolbox Fluid Cognition Battery, which tested episodic memory, working memory, attention and inhibitory control, processing speed, and cognitive flexibility. The primary analyses were conducted using age-corrected standard scores, where a score of 100 represented the national average for a representative sample at the test taker’s age.  

The findings revealed that the mean age-corrected standard score for overall fluid cognition among adults with SLE was 87.2. Notably, attention and inhibitory control emerged as the domain with the lowest mean score (82), with 28% of participants potentially impaired in this area. Further analysis identified factors associated with a lower risk of fluid cognition impairment, including current employment (odds ratio [OR]: 0.3; 95% confidence interval [Cl]: 0.14–0.64), higher self-reported physical function (OR: 0.46; 95% CI: 0.28–0.75), and better physical performance (OR: 0.72; 95% CI: 0.59–0.87). Conversely, lower educational attainment was linked to a higher risk of impairment (OR: 3.82; 95% CI: 1.67–8.75).  

“In our research, there has been a recurring theme that patients with SLE often feel they are in a ‘lupus fog’ and that this fog is one of the most frustrating symptoms that they experience,” Plantinga said. “Better understanding the underlying issues could help us better support patients who experience these symptoms.” 

The study underscores the importance of understanding and addressing cognitive impairment in patients with SLE, and highlights the potential for targeted interventions to improve patient outcomes and quality of life. However, further research in this area is needed to develop effective strategies for managing these symptoms in patients. 



Plantinga LC et al. Fluid cognition among individuals with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2024;DOI:10.1002/acr.25330. 


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