Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus

Michelle Petri, Mohammad Naqibuddin, Kathryn Anne Carson, Daniel J. Wallace, Michael H. Weisman, Stephen L. Holliday, Margaret Sampedro, Patricia A. Padilla, Robin L. Brey

Research output: Contribution to journalArticle

Abstract

Objective. Cognitive impairment is present in 80% of patients with systemic lupus erythematosus (SLE) 10 years after diagnosis. The natural history of cognitive dysfunction in newly diagnosed SLE is unknown. We examined the association of depression and cognitive performance in newly diagnosed SLE. Methods. A multicenter cohort of 111 patients newly diagnosed (within 9 months) with SLE underwent cognitive function testing using an automated battery [Automated Neuropsychological Assessment Metrics (ANAM)] with 9 subtests. Depression was measured using the Calgary Depression Scale (CDS). Results. The patient cohort was 97.3% female, 55.9% white, 15.3% African American, 20.7% Hispanic, mean age 37.8 years, mean education 15.2 years. CDS score ranged from 0 to 18 (mean 5.0 ± 4.6). CDS score did not differ by age, sex, ethnicity, or prednisone dose. Higher Krupp Fatigue Severity Scale scores and presence of fibromyalgia were significantly associated with higher CDS score (p <0.001; p = 0.006, respectively). Depressed patients, defined by a CDS score > 6, had significantly poorer performance on 5 ANAM throughput measures: code substitution (p = 0.03), continuous performance (p = 0.02), matching-to-sample (p = 0.04), simple reaction time (p = 0.02), and the Sternberg memory test (p = 0.04). Adjusting for age, sex, ethnicity, education, and prednisone dose, a higher CDS score remained significantly associated with poorer performance on 3 measures, but the association was slightly attenuated for code substitution and matching-to-sample. Depression was not associated with mathematical or spatial processing. Conclusion. Depression, a modifiable risk factor, is associated with significantly poorer function in several cognitive domains in patients newly diagnosed with SLE. Treatment of depression when the CDS score is greater than 6 may improve cognitive functioning and should be further studied. The Journal of Rheumatology

Original languageEnglish (US)
Pages (from-to)2032-2038
Number of pages7
JournalJournal of Rheumatology
Volume37
Issue number10
DOIs
StatePublished - Oct 2010

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Systemic Lupus Erythematosus
Depression
Prednisone
Cognitive Dysfunction
Sex Education
Fibromyalgia
Rheumatology
Hispanic Americans
African Americans
Cognition
Reaction Time
Fatigue
Education

Keywords

  • Automated neuropsychological assessment metrics
  • Depression
  • Systemic lupus erythematosus

ASJC Scopus subject areas

  • Rheumatology
  • Immunology
  • Immunology and Allergy

Cite this

Petri, M., Naqibuddin, M., Carson, K. A., Wallace, D. J., Weisman, M. H., Holliday, S. L., ... Brey, R. L. (2010). Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus. Journal of Rheumatology, 37(10), 2032-2038. https://doi.org/10.3899/jrheum.091366

Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus. / Petri, Michelle; Naqibuddin, Mohammad; Carson, Kathryn Anne; Wallace, Daniel J.; Weisman, Michael H.; Holliday, Stephen L.; Sampedro, Margaret; Padilla, Patricia A.; Brey, Robin L.

In: Journal of Rheumatology, Vol. 37, No. 10, 10.2010, p. 2032-2038.

Research output: Contribution to journalArticle

Petri, M, Naqibuddin, M, Carson, KA, Wallace, DJ, Weisman, MH, Holliday, SL, Sampedro, M, Padilla, PA & Brey, RL 2010, 'Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus', Journal of Rheumatology, vol. 37, no. 10, pp. 2032-2038. https://doi.org/10.3899/jrheum.091366
Petri, Michelle ; Naqibuddin, Mohammad ; Carson, Kathryn Anne ; Wallace, Daniel J. ; Weisman, Michael H. ; Holliday, Stephen L. ; Sampedro, Margaret ; Padilla, Patricia A. ; Brey, Robin L. / Depression and cognitive impairment in newly diagnosed systemic lupus erythematosus. In: Journal of Rheumatology. 2010 ; Vol. 37, No. 10. pp. 2032-2038.
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AB - Objective. Cognitive impairment is present in 80% of patients with systemic lupus erythematosus (SLE) 10 years after diagnosis. The natural history of cognitive dysfunction in newly diagnosed SLE is unknown. We examined the association of depression and cognitive performance in newly diagnosed SLE. Methods. A multicenter cohort of 111 patients newly diagnosed (within 9 months) with SLE underwent cognitive function testing using an automated battery [Automated Neuropsychological Assessment Metrics (ANAM)] with 9 subtests. Depression was measured using the Calgary Depression Scale (CDS). Results. The patient cohort was 97.3% female, 55.9% white, 15.3% African American, 20.7% Hispanic, mean age 37.8 years, mean education 15.2 years. CDS score ranged from 0 to 18 (mean 5.0 ± 4.6). CDS score did not differ by age, sex, ethnicity, or prednisone dose. Higher Krupp Fatigue Severity Scale scores and presence of fibromyalgia were significantly associated with higher CDS score (p <0.001; p = 0.006, respectively). Depressed patients, defined by a CDS score > 6, had significantly poorer performance on 5 ANAM throughput measures: code substitution (p = 0.03), continuous performance (p = 0.02), matching-to-sample (p = 0.04), simple reaction time (p = 0.02), and the Sternberg memory test (p = 0.04). Adjusting for age, sex, ethnicity, education, and prednisone dose, a higher CDS score remained significantly associated with poorer performance on 3 measures, but the association was slightly attenuated for code substitution and matching-to-sample. Depression was not associated with mathematical or spatial processing. Conclusion. Depression, a modifiable risk factor, is associated with significantly poorer function in several cognitive domains in patients newly diagnosed with SLE. Treatment of depression when the CDS score is greater than 6 may improve cognitive functioning and should be further studied. The Journal of Rheumatology

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