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Risk Factors for Cognitive Impairment in SLE

Purpose: To identify factors that may affect the severity of cognitive impairment in a patient with SLE as reported by Tomietto et al.

Description

Tomietto et al identified a number of risk factors associated with cognitive impairment in patients with systemic lupus erythematosus (SLE). These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Udine, the Catholic University of Rome, and Santa Maria della Misericordia Hospital of Udine in Italy.


 

Patient selection: systemic lupus erythematosus (SLE)

 

Factors affecting the severity of cognitive impairment and/or the number of cognitive functions impaired:

(1) hypertension

(2) antiphospholipid antibody

(3) accumulated damage (as measured with the SLICC/ACR Damage Index, 22.07.03), with risk associated with index >= 1)

(4) moderate or severe changes in the cerebral MRI

(5) Raynaud's phenomenon

(6) obesity

 

The presence of both antiphospholipid antibody and Raynaud's phenomenon is associated with a higher rate of moderate to severe cognitive deficits.

 

Patients with more severe cognitive impairment tended to have a lower level of education.

 

Interventions that may reduce cognitive impairment may include:

(1) control of hypertension

(2) weight control

(3) vasodilator therapy in patient's with Raynaud's phenomenon

(4) anticoagulant therapy in patients with antiphospholipid antibody

(5) early and aggressive therapy of the SLE to reduce accumulated damage

 


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Specialty

Objective

ICD-10