Cardiovascular disease and cognitive dysfunction in systemic lupus erythematosus
Arthritis Care & Research , 05/02/2012
Murray SG et al. – The results suggest that the presence of antiphospholipid antibodies (aPL), hypertension, and stroke are key variables associated with cognitive impairment, which may aid in identification of patients at greatest risk.Methods
- Subjects included 694 participants from the Lupus Outcomes Study (LOS), a longitudinal study of SLE outcomes based on annual telephone survey querying demographic and clinical variables.
- The Hopkins Verbal Learning Test – Revised (HVLT–R) and the Controlled Oral Word Association Test (COWAT) were administered to assess cognitive function.
- Multiple logistic regression was used to identify cardiovascular events (myocardial infarction (MI), stroke), traditional cardiovascular risk factors (hypertension, hyperlipidemia, diabetes, obesity, smoking), and SLE–specific risk factors (antiphospholipid antibodies (aPL), disease activity, disease duration) associated with cognitive impairment in year seven of the LOS.
- The prevalence of cognitive impairment as measured by verbal memory and verbal fluency metrics was 15%.
- In adjusted multiple logistic regression analyses, aPL (OR=2.10, 95% CI 1.3–3.41), hypertension (OR=2.06, 95% CI 1.19–3.56), and a history of stroke (OR=2.27, 95% CI 1.16–4.43) were significantly associated with cognitive dysfunction.
- In additional analyses evaluating the association between these predictors and severity of cognitive impairment, stroke was significantly more prevalent in participants with severe impairment when compared to those with mild or moderate impairment (p=0.036).