Background Neuropsychiatric manifestations in systemic lupus erythematosus (SLE) is common and affects some 45 - 70% of SLE patients during the course of this chronic relapsing remitting multisystem autoimmune disease. Less well known is the prevalence of the more subtle memory dysfunction - with 4 Sub-domains - which together constitutes part of the cognitive process.
Objectives This study aimed to determine the prevalence of memory dysfunction and its associated risk factors among SLE patients on follow up at both the Rheumatology and Nephrology/SLE clinics, UKM Medical Center.
Methods This was a prospective, cross-sectional study which recruited SLE patients without a past history of overt central nervous system (CNS) lupus. These patients were interviewed and assessed using the Wechsler Memory Scale-4th edition UK version (WMS-IVUK). Based on their WMS-IVUK scores, they were then categorized as having impaired memory or non-impaired memory. Their SLE disease activities were determined by clinical features together with blood and urine parameters.
Results A total of 54 patients were screened, 40 fulfilled the criteria but only 15 consented to participate. There were 14 females and only one male. Majority of them (n=12, 80%) had tertiary education. Memory dysfunction was identified in 7/15 (46.7%). There was a significant association between memory dysfunction and lower serum thyroxine levels (p=0.027*). No associations were found between memory dysfunction and any of the lupus autoantibodies nor complement levels nor with the use of corticosteroids and other immunomodulatory treatment. The score in 3 out of 4 sub-domains of memory were significantly different between non-impaired and impaired memory group (visual memory, p=0.004**, immediate memory, p= 0.009**; delayed memory, p=0.012*). The auditory memory was associated with lower education level (p=0.025*), cumulative number of organ systems involved (p=0.012*) and cumulative number of treatments (p=0.029*). Whereas visual memory was influenced by disease duration (p=0.016*).
Conclusions There is a high prevalence of hitherto under-recognized memory dysfunction amongst SLE patients. The risk factors for these were included serum thyroxine, disease duration, cumulative number of organ systems involvement and cumulative number of treatments. However, the small number of patients studied does not permit these results to be generalized to the rest of our SLE patients. A larger study is indicated.
Disclosure of Interest: None Declared
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