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Geriatric Assessment of Physical and Cognitive Functioning in a Diverse Cohort of Systemic Lupus Erythematosus Patients: A Pilot Study
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August 27 2018
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Source: Arthritis Care Res (Hoboken). 70(10):1469-1477
[PDF-1.41 MB]
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Alternative Title:Arthritis Care Res (Hoboken)
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Personal Author:
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Description:Objective
To use multi-domain functional assessment, commonly performed in geriatric patients but novel among SLE patients, to better understand functional impairment in SLE.
Methods
We recruited 60 adult participants [aged 20–39 (26.7%), 40–59 (50.0%), and ≥60 (23.3%); 80.0% black; 90.0% female] from an existing cohort of SLE patients. During in-person visits (10/16–4/17), we evaluated physical performance (range 0–4; higher scores = better performance); cognitive performance (five fluid cognition domains; adjusted t-scores); and self-reported measures including physical functioning (t-scores), activities of daily living (ADLs), falls, and life-space mobility.
Results
Mean (±SD) balance (3.7±0.8) and gait speed (3.4±1.0) scores were high, while the mean lower body strength score was low (1.8±1.3). Cognitive performance was average (score=50) for episodic (47.7±9.2) and working (48.6±11.2) memory and low average for cognitive flexibility (43.7±14.2), processing speed (42.6±14.8), and attention/inhibitory control (38.8±8.6; >1 SD below average), compared to healthy individuals of the same age, sex, race, ethnicity, and education. Most participants reported independence in basic ADLs but many reported dependence in instrumental ADLs. Nearly half (45.0%) of participants reported falling in the prior year. Only 40.0% reported unlimited ability to travel without the help of another person. Scores generally did not differ substantially by age.
Conclusion
Our results suggest high prevalence of impairment across multiple domains of function in SLE patients of all ages, similar to or exceeding the prevalence seen in much older geriatric populations. Further research into the added value of geriatric assessment in routine care for SLE is warranted.
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Pubmed ID:29316334
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Pubmed Central ID:PMC6033700
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