AB1417-HPR Predictors of cognitive dysfunction in patients with lupus
Authors: H Alessi, L.A. Dutra, L.A. Maria, P.C. Coube, O.G.P. Barsottini, C. Kayser, A.W.S D.Souza
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Cognitive Dysfunction (CD) is one of the most common neuropsychiatric manifestations in systemic lupus erythematosus (SLE). CD occurs independently of structural damage(<sup>1,2</sup> or disease activity(,<sup>3</sup> impacts life quality(.<sup>4</sup> Cardiovascular comorbidities, lower educational level and physical inactivity are risk factors for dementia in elderly worldwide(<sup>6</sup> and are frequently found in SLE patients. Identifying the factors involved with CD in SLE can clarify physiopathological processes and preventive measures. <h3>Objectives</h3> To verify if cardiovascular comorbidities and physical inactivity are predictors of CD in Brazilian patients with SLE. <h3>Methods</h3> a 168 patients and healthy controls between 18 and 59 years were allocated into three groups: CON (n=57), SLEG (n=63) and NPSLE (n=48). Epidemiological information, laboratory results, medication use, cardiovascular comorbidities (hypertension, diabetes, dyslipidemia, previous myocardial infarction), SLICC and SLEDAI scores were compiled from charts. Variables were compared using ANOVA, Kruskall-Wallis, Mann-Whitney and Qui-square, and p&lt;0.05. <h3>Results</h3> There were no differences between groups regarding age, educational level. There was also no difference in prevalence of diabetes, myocardial infarction, tobacco use and disease duration. SLEG and NPSLE had more hypertension (CON 18.9%; SLEG 55.6%; NPSLE 39.6%) and dyslipidemia than controls (CON 9.4%; SLEG 36.5%; NPSLE 39.6%). SLE patients presented more depression (p&lt;0.001), anxiety (CON 9.5±8.3; SLEG 16.3±13.3; NPSLE 14.1±10.9; p=0.008) and lower levels of physical activities than controls. NPLES group presented more CD (CON 21.1%; SLEG 34.9%; NPSLE 62.5%) when compared to CON (p&lt;0.001) and SLEG (p=0.012). Major neuropsychiatric manifestations (OR 2.460; 95% CI 1.007–6.008; p=0.048); low educational level (OR 0.870; 95% CI 0.756–1.000; p=0.050), anxiety (OR 1.031; 95% CI 0.994–1.069; p=0.096), and disease damage (OR 1.691; 95% CI 1.175–62.435; p=0.005) were independently associated with CD. <h3>Conclusions</h3> Neuropsychiatric manifestation, low educational level, anxiety and disease damage are predictors of CD in patients with SLE. Although cardiovascular comorbidity and sedentary lifestyle are a risk factor for dementia in general population, those variables might play a minor role in SLE patients. <h3>References</h3> [1] Kozora E, West SG, Kotzin BL, Julian L, Porter S, Bigler E. Magnetic resonance imaging abnormalities and cognitive deficits in systemic lupus erythematosus patients without overt central nervous system disease. Arthritis Rheum. 1998Jan;41(1):41–7. [2] Kozora E, Thompson LL, West SG, Kotzin BL. Analysis of cognitive and psychological deficits in systemic lupus erythematosus patients without overt central nervous system disease. Arthritis Rheum. 1996;39(12):2035–45. [3] Liang M, Corzillius M, Bae S, Lew RA, Fortin PR, Gordon C. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599–608. [4] Panopalis P, Julian L, Yazdany J, Gillis JZ, Trupin L, Hersh A, et al. Impact of memory impairment on empployment status in persons with sistemic lupus erythematosus. Arthritis Rheum. 2007;57(8):1453–60. [5] Livingston G, Sommerlad A,Orgeta V, Costafreda SG, Huntley J, Ames D, et al. Dementia prevention, intervention, and care. Lancet.2017;6736(17). <h3>Disclosure of Interest</h3> None declared