Screening for cognitive impairment in SLE using the Self-Administered Gerocognitive Exam

• Published in: Lupus 2018-07, Vol.27 (8), p.1363-1367
• Main Authors: Meara, A, Davidson, N, Steigelman, H, Zhao, S, Brock, G, Jarjour, W N, Rovin, B H, Madhoun, H, Parikh, S, Hebert, L, Ayoub, I, Ardoin, S P
• Format: Article
• Language: English
• Subjects: Central nervous system; Cognition; Cognitive ability; Ethnicity; Lupus; Minority & ethnic groups; Systemic lupus erythematosus
• ISSN: 0961-2033; 1477-0962
• DOI: 10.1177/0961203318759429

Objective Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can affect the central nervous system in multiple ways, including causing cognitive dysfunction. Cognitive dysfunction is a common complaint of SLE patients yet diagnosis is challenging, time consuming, and costly. This study evaluated the Self-Administered Gerocognitive Exam (SAGE) as a screening test for cognitive impairment in a cohort of SLE patients. Methods A total of 118 SLE patients completed the SAGE. Providers completed the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and the Systemic Lupus International Collaborative Clinics Damage Index (SLICC-DI). SAGE scores were grouped into normal (>16) and abnormal (≤16) categories. Univariate and multivariate analyses were performed. Results Of the 118 participants, 21(18%) scored ≤16 on the SAGE instrument. In univariate analysis, race, ethnicity, household income, and SLICC-DI scores were associated with the SAGE (p $50,000, 95% CI 2.45–57, p = 0.002). Conclusions In SLE patients, this study demonstrates an independent relationship between neurocognitive impairment (as measured by the SAGE) and higher lupus-related damage, as measured by the SLICC-DI, and lower household income. Abnormal SAGE scores were also associated with Hispanic ethnicity. A language barrier could explain this because the SAGE instrument was conducted in English only. The SAGE was feasible to measure in the clinic setting.