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Faulkner KM, Dickson VV, Fletcher J, Katz SD, Chang PP, Gottesman RF, Witt LS, Shah AM, D'Eramo Melkus G. Factors Associated With Cognitive Impairment in Heart Failure With Preserved Ejection Fraction. J Cardiovasc Nurs 2022; 37:17-30. [PMID: 32649377 PMCID: PMC9069246 DOI: 10.1097/jcn.0000000000000711] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cognitive impairment is prevalent in heart failure and is associated with higher mortality rates. The mechanism behind cognitive impairment in heart failure with preserved ejection fraction (HFpEF) has not been established. OBJECTIVE The aim of this study was to evaluate associations between abnormal cardiac hemodynamics and cognitive impairment in individuals with HFpEF. METHODS A secondary analysis of Atherosclerosis Risk in Communities (Atherosclerosis Risk in Communities) study data was performed. Participants free of stroke or dementia who completed in-person assessments at visit 5 were included. Neurocognitive test scores among participants with HFpEF, heart failure with reduced ejection fraction (HFrEF), and no heart failure were compared. Sociodemographics, comorbid illnesses, medications, and echocardiographic measures of cardiac function that demonstrated significant (P < .10) bivariate associations with neurocognitive test scores were included in multivariate models to identify predictors of neurocognitive test scores among those with HFpEF. Multiple imputation by chained equations was used to account for missing values. RESULTS Scores on tests of attention, language, executive function, and global cognitive function were worse among individuals with HFpEF than those with no heart failure. Neurocognitive test scores were not significantly different among participants with HFpEF and HFrEF. Worse diastolic function was weakly associated with worse performance in memory, attention, and language. Higher cardiac index was associated with worse performance on 1 test of attention. CONCLUSIONS Cognitive impairment is prevalent in HFpEF and affects several cognitive domains. The current study supports the importance of cognitive screening in patients with heart failure. An association between abnormal cardiac hemodynamics and cognitive impairment was observed, but other factors are likely involved.
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Kewcharoen J, Prasitlumkum N, Kanitsoraphan C, Charoenpoonsiri N, Angsubhakorn N, Putthapiban P, Rattanawong P. Cognitive impairment associated with increased mortality rate in patients with heart failure: A systematic review and meta-analysis. J Saudi Heart Assoc 2019; 31:170-178. [PMID: 31320786 PMCID: PMC6614112 DOI: 10.1016/j.jsha.2019.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/25/2019] [Accepted: 06/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background Recent systematic review and meta-analysis showed that the prevalence of cognitive impairment was significantly increased in patients with heart failure (HF) when compared to the general population. However, the effect of cognitive impairment on cardiovascular outcome in this population is still unclear. We performed a systematic review and meta-analysis to assess whether cognitive impairment associated with worse outcome in patients with HF. Methods We comprehensively searched the databases of MEDLINE and EMBASE from inception to October 2018. Included studies were published cohort (prospective or retrospective) or randomized control trials that evaluate the effect of cognitive impairment mortality in HF patients. Data from each study were combined using the random-effects, generic inverse variance method of DerSimonian and Laird to calculate pooled hazard ratios (HR) and 95% confidence intervals (CI). Results Eight studies were included in the analysis involving 3318 participants (951 participants had cognitive impairment). In a random-effects model, our analysis demonstrated that cognitive impairment significantly increased the risk of mortality in HF patients (pooled HR = 1.64, 95% CI = 1.42–1.88, I2 = 0.0%, p < 0.001). Conclusion Our systematic review and meta-analysis showed that the presence of cognitive impairment is strongly associated with an increased mortality risk in the HF population. Further research is needed to explore the pathophysiology of this association.
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Affiliation(s)
- Jakrin Kewcharoen
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Corresponding author at: 1212 Nuuanu ave, Honolulu, HI 96817, USA.
| | - Narut Prasitlumkum
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
| | | | - Nattawat Charoenpoonsiri
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | | | - Pattara Rattanawong
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Cognitive Function Is Associated With Mobility in Community Dwelling Older Adults With a History of Cardiovascular Disease. Cardiopulm Phys Ther J 2019. [DOI: 10.1097/cpt.0000000000000095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Kewcharoen J, Trongtorsak A, Kanitsoraphan C, Prasitlumkum N, Mekritthikrai R, Techorueangwiwat C, Limpruttidham N, Rattanawong P. Cognitive impairment and 30-day rehospitalization rate in patients with acute heart failure: A systematic review and meta-analysis. Indian Heart J 2019; 71:52-59. [PMID: 31000183 PMCID: PMC6477121 DOI: 10.1016/j.ihj.2018.12.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/22/2018] [Accepted: 12/26/2018] [Indexed: 12/20/2022] Open
Abstract
Background Heart failure (HF) is one of the world leading causes of hospitalization and rehospitalization. Cognitive impairment has been identified as a risk factor for rehospitalization in patients with heart failure. However, previous studies reported mixed results. Therefore, we conducted a systematic review and meta-analysis to assess the association between cognitive impairment and 30-day rehospitalization in patients with HF. Method We performed a comprehensive literature search through July 2018 in the databases of MEDLINE and EMBASE. Included studies were cohort studies, case-control studies, cross-sectional studies or randomized controlled trials that compared the risk of 30-day rehospitalization in HF patients with cognitive impairment and those without. We calculated pooled relative risk (RR) with 95% confidence intervals (CI) and I2 statistic using the random-effects model. Results Five studies with a total of 2,342 participants (1,004 participants had cognitive impairment) were included for meta-analysis. In random-effect model, cognitive impairment significantly increased the risk of 30-day rehospitalization in HF participants (pooled RR=1.63, 95%CI: 1.19-2.24], I2=64.2%, p=0.002). Subgroup analysis was performed on the studies that excluded patients with dementia. The results also showed that cognitive impairment significantly increased the risk of 30-day rehospitalization in participants with HF (pooled RR=1.29, 95%CI: 1.05–1.59, I2=0.0%, p=0.016), which was consistent with our overall analysis. Conclusion Our meta-analysis demonstrated that the presence of cognitive impairment is associated with 30-day rehospitalization in patients with HF.
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Affiliation(s)
- Jakrin Kewcharoen
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA; Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Angkawipa Trongtorsak
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Narut Prasitlumkum
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
| | | | - Chol Techorueangwiwat
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nath Limpruttidham
- University of Hawaii Internal Medicine Residency Program, Honolulu, HI, USA
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Abstract
BACKGROUND Cognitive impairment is prevalent in heart failure (HF) with severe consequences, including increased risk of mortality and reduced ability to self-manage HF symptoms. Identifying cognitive impairment through screening would assist clinicians in managing HF and comorbid cognitive impairment. However, the accuracy of cognitive screening instruments for HF has not been adequately determined. OBJECTIVE The aim of this study was to determine the diagnostic accuracy of cognitive screening instruments in screening for mild cognitive impairment (MCI) in HF patients. METHODS A systematic review of major electronic bibliographic databases was searched from January 1999 to June 2013. Inclusion criteria were as follows: primary studies examining cognitive impairment in HF, administration of a cognitive screening instrument and neuropsychological test battery, and cognitive impairment indicated by performance on neuropsychological tests 1.5 SDs less than that of normative data. Methodological rigor of included publications was evaluated using 2 bias risk instruments: QUality Assessment of Diagnostic Accuracy Studies and STAndards for the Reporting of Diagnostic accuracy studies. The precision, accuracy, and receiver operating characteristic curves of the Mini Mental State Examination were computed. RESULTS From 593 citations identified, 8 publications met inclusion criteria. Risk of bias included selective HF patient samples, and no study examined the diagnostic test accuracy of the cognitive screening instruments. The Mini Mental State Examination had low sensitivity (26%) and high specificity (95%) with a score of 28 or less as the optimal threshold for MCI screening. CONCLUSIONS Screening for cognitive impairment in HF is recommended; however, future studies need to establish the diagnostic accuracy of screening instruments of MCI in this population.
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Kara K, Mahabadi AA, Weimar C, Winkler A, Neumann T, Kälsch H, Dragano N, Moebus S, Erbel R, Jöckel KH, Jokisch M. N-Terminal Pro-B Type Natriuretic Peptide is Associated with Mild Cognitive Impairment in the General Population. J Alzheimers Dis 2016; 55:359-369. [PMID: 27636851 DOI: 10.3233/jad-160635] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Kaffer Kara
- Cardiovascular Center, St. Josef-Hospital, Ruhr-University Bochum, Bochum, Germany
| | - Amir Abbas Mahabadi
- West-German Heart and Vascular Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany
| | - Christian Weimar
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Angela Winkler
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
| | - Till Neumann
- West-German Heart and Vascular Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany
| | - Hagen Kälsch
- West-German Heart and Vascular Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany
| | - Nico Dragano
- Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Germany
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González-Moneo MJ, Sánchez-Benavides G, Verdu-Rotellar JM, Cladellas M, Bruguera J, Quiñones-Ubeda S, Enjuanes C, Peña-Casanova J, Comín-Colet J. Ischemic aetiology, self-reported frailty, and gender with respect to cognitive impairment in chronic heart failure patients. BMC Cardiovasc Disord 2016; 16:163. [PMID: 27577747 PMCID: PMC5006572 DOI: 10.1186/s12872-016-0349-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 08/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background Decisive information on the parameters involved in cognitive impairment in patients with chronic heart failure is as yet lacking. Our aim was to determine the functional and psychosocial variables related with cognitive impairment using the mini-mental-state examination (MMSE) with age-and education-corrected scores. Methods A cohort study of chronic heart failure patients included in an integrated multidisciplinary hospital/primary care program. The MMSE (corrected for age and education in the Spanish population) was administered at enrolment in the program. Analyses were performed in 525 patients. Demographic and clinical variables were collected. Comprehensive assessment included depression (Yesavage), family function (family APGAR), social network (Duke), dependence (Barthel Index), frailty (Barber), and comorbidities. Univariate and multivariate logistic regression were performed to determine the predictors of cognitive impairment. Results Cognitive impairment affected 145 patients (27.6 %). Explanatory factors were gender (OR: 2.77 (1.75–4.39) p < 0.001), ischemic etiology (OR: 1.99 (1.25–3.17) p = 0.004), frailty (OR: 1.58 (0.99 to 2.50, p =0.050), albumin > 3.5 (OR: 0.59 (0.35–0.99) p = 0.048), and beta-blocker treatment (OR: 0.36 (0.17 to 0.76, p = 0.007)). No association was found between cognitive impairment and social support or family function. Conclusion The observed prevalence of cognitive impairment using MMSE corrected scores was 27.6 %. A global approach in the management of these patients is needed, especially focusing on women and patients with frailty, low albumin levels, and ischemic aetiology heart failure.
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Affiliation(s)
- María J González-Moneo
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain.,San Martin Primary Care Center, Barcelona, Spain.,Jordi Gol University Institute for Research Primary Healthcare, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Neurofunctionality of Brain and Language Group, Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - José M Verdu-Rotellar
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain.,San Martin Primary Care Center, Barcelona, Spain.,Jordi Gol University Institute for Research Primary Healthcare, Barcelona, Spain
| | - Mercé Cladellas
- Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain
| | - Jordi Bruguera
- Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain
| | - Sonia Quiñones-Ubeda
- Neurofunctionality of Brain and Language Group, Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Cristina Enjuanes
- Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain
| | - Jordi Peña-Casanova
- Neurofunctionality of Brain and Language Group, Neurosciences Research Programme, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Josep Comín-Colet
- Grup de recerca biomedica en malalties del cor GREC (Heart Diseases Biomedical Research Group), IMIM (Hospital del Mar Medical Research Institute), 88, Doctor Aiguader, 08003, Barcelona, Spain.
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Giovannelli F, Simoni D, Gavazzi G, Giganti F, Olivotto I, Cincotta M, Pratesi A, Baldasseroni S, Viggiano MP. Electrophysiological correlates of word recognition memory process in patients with ischemic left ventricular dysfunction. Clin Neurophysiol 2016; 127:3007-3013. [PMID: 27469528 DOI: 10.1016/j.clinph.2016.06.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 06/22/2016] [Accepted: 06/23/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The relationship between left ventricular ejection fraction (LVEF) and cognitive performance in patients with coronary artery disease without overt heart failure is still under debate. In this study we combine behavioral measures and event-related potentials (ERPs) to verify whether electrophysiological correlates of recognition memory (old/new effect) are modulated differently as a function of LVEF. METHODS Twenty-three male patients (12 without [LVEF>55%] and 11 with [LVEF<40%] left ventricular dysfunction), and a Mini Mental State Examination score >25 were enrolled. ERPs were recorded while participants performed an old/new visual word recognition task. RESULTS A late positive ERP component between 350 and 550ms was differentially modulated in the two groups: a clear old/new effect (enhanced mean amplitude for old respect to new items) was observed in patients without LVEF dysfunction; whereas patients with overt LVEF dysfunction did not show such effect. In contrast, no significant differences emerged for behavioral performance and neuropsychological evaluations. CONCLUSIONS These data suggest that ERPs may reveal functional brain abnormalities that are not observed at behavioral level. SIGNIFICANCE Detecting sub-clinical measures of cognitive decline may contribute to set appropriate treatments and to monitor asymptomatic or mildly symptomatic patients with LVEF dysfunction.
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Affiliation(s)
- Fabio Giovannelli
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy; Unit of Neurology, Florence Health Authority, Florence, Italy
| | - David Simoni
- Department of Heart and Vessels, Geriatric Cardiology and Medicine Unit University of Florence and Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy
| | - Gioele Gavazzi
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | - Fiorenza Giganti
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | | | | | - Alessandra Pratesi
- Department of Heart and Vessels, Geriatric Cardiology and Medicine Unit University of Florence and Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy
| | - Samuele Baldasseroni
- Department of Heart and Vessels, Geriatric Cardiology and Medicine Unit University of Florence and Azienda Ospedaliero-Universitaria Careggi (AOUC), Florence, Italy
| | - Maria Pia Viggiano
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy.
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Yzeiraj E, Tam DM, Gorodeski EZ. Management of Cognitive Impairment in Heart Failure. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2016; 18:4. [PMID: 26747626 DOI: 10.1007/s11936-015-0425-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OPINION STATEMENT Cognitive impairment (CI) is an inclusive term to describe trouble with memory, learning, concentration, or decision-making. CI is highly prevalent in patients with heart failure (HF) and is known to be associated with a variety of poor outcomes. While published HF guidelines recommend screening for CI, they do not indicate how, due to a lack of consensus in the literature about which instrument to use. Our recommendation is to use the Mini-Cog for this purpose because of its brevity and utility in identifying patients with HF at high risk for hospitalization or mortality. At this time, there is minimal published clinical trial evidence about how to manage CI in patients with HF. Reasonable approaches to management may include following guideline-directed medical therapy for HF, treatment of hypertension and atrial fibrillation, management of depression, proactive diagnosis and treatment of sleep apnea, and encouragement of aerobic exercise and weight loss. Left ventricular assist device (LVAD) therapy in patients with Stage D HF may improve CI in the short term after implantation, though there is a risk of worsening CI in the intermediate and long term. Clinicians who care for patients with HF should routinely screen for CI and when identified should encourage interventions to support self-care, increase family involvement, and arrange for more frequent follow-up.
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Affiliation(s)
- Edlira Yzeiraj
- Department of Internal Medicine, Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Danny M Tam
- NYU Comprehensive Epilepsy Center, New York, NY, USA
| | - Eiran Z Gorodeski
- Section of Heart Failure and Cardiac Transplantation, Tomsich Family Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
- Center for Connected Care, Cleveland Clinic, Desk J3-4, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
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Cambridge Neuropsychological Test Automated Battery in assessment of cognitive parameters in patients with systemic lupus erythematosus in relation to autoantibody profile. Reumatologia 2015; 53:131-8. [PMID: 27407239 PMCID: PMC4847298 DOI: 10.5114/reum.2015.53134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 06/12/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives To relate the cognitive parameters of systemic lupus erythematosus (SLE) patients in remission to their profile of autoantibodies. Material and methods The study included 32 patients with SLE in remission, with mild disease activity as indicated by SELENA-SLEDAI < 6. For neuropsychological assessment, the Cambridge Neuropsychological Test Automated Battery (CANTAB) was applied, using motor screening (MOT), big little circle (BLC), paired associated learning (PAL), stockings of Cambridge (SOC), and graded naming tests (GNT). Detection of autoantibodies against dsDNA, nucleosome (aNuc), Sm, and anticardiolipin (aCL: IgG and IgM) was performed with immunoassays. Results The SLE patients demonstrated standard scores below norms, matched according to age and gender, in the following tests: GNT (–0.87 ±0.85), SOC PSMM (–0.47 ±0.97), PAL (–1.88 ±3.58), and BLC (–0.31 ±1.90). GNT scores under –0.5 were found significantly more frequently in SLE patients, seen in roughly 66% of test subjects. Values for PAL and mean subsequent thinking time of stockings of Cambridge (SOC MSTT) were found to be lower than –0.5 in approximately half of the patients. Mean error of motor screening (MOT ME) was found to negatively correlate with mean latency of motor screening (MOT ML) (r = –0.55). PAL significantly correlated with SOC MSTT (r = 0.38) and with GNT (r = 0.36). Anti-dsDNA antibody level correlated negatively with MOT ME (r = –0.46). Anti-Nuc antibodies correlated with MOT ML (r = 0.41) but negatively correlated with MOT ME (r = –0.58). The levels of anti-Sm, anti-CL IgM and IgG did not correlate significantly with the outcomes of CANTAB. The age of the patients correlated negatively with MOT ME (r = –0.36), positively with BLC (r = 0.53) and negatively with SOC MSTT (r = –0.43). The level of anti-Nuc antibodies correlated with anti-dsDNA level (r = 0.62) and of anti-CL IgM with anti-Sm (r = 0.39) and anti-CL IgG (r = 0.87). Conclusions CANTAB reveals a decrease in selected cognitive functions in patients with SLE. ACL IgG and anti-dsDNA antibodies indicated SLE patients prone to develop a decrease in cognitive functions.
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