RESEARCH - Cognitive impairment and employment status in SLE

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Arthritis Rheum. 2009 Apr 29;61(5):680-687.

Cognitive impairment and employment status in systemic lupus

erythematosus: A prospective longitudinal study.

Appenzeller S, Cendes F, Costallat LT.

University of Campinas, São o, Brazil.

OBJECTIVE: To determine the relationship between cognitive impairment

and employment in patients with systemic lupus erythematosus (SLE).

METHODS: A total of 167 consecutive patients with SLE were

prospectively evaluated, and underwent standardized neuropsychological

tests. Multivariate logistic regression was used to determine the

likelihood of being unemployed, adjusting for sociodemographic

characteristics, employment status at study entry, disease activity,

disease duration, damage scores, and depression.

RESULTS: At study entry, 118 (70.7%) of 167 patients were employed. In

the multivariate analysis, after adjusting for confounders,

unemployment was predicted by the number of cognitive domains impaired

(odds ratio [OR] 1.76, 95% confidence interval [95% CI] 1.58-6.72),

depression (OR 1.3, 95% CI 1.1-3.1), fewer years of education (OR

0.12, 95% CI 0.02-0.34), and the presence of anticardiolipin

antibodies (OR 1.43, 95% CI 1.2-6.1). Complex attention (OR 1.7, 95%

CI 1.2-3.6), memory (OR 3.1, 95% CI 1.5-6.2), and executive functions

(OR 2.4, 95% CI 1.9-6.1) were predictors of unemployment at study

entry. After 3 years, 61 (51.7%) of 118 patients were employed (OR

2.25, 95% CI 1.38-3.68; P = 0.001). The likelihood of being unemployed

after 3 years was predicted by the number of cognitive domains

impaired (OR 3.8, 95% CI 2.5-7.71), depression (OR 2.31, 95% CI

1.01-5.21), fewer years of education (OR 0.09, 95% CI 0.01-0.42), and

the presence of anticardiolipin antibodies (OR 2.1, 95% CI 1.2-4.9).

Complex attention (OR 2.2, 95% CI 1.1-3.8), memory (OR 3.6, 95% CI

2.1-6.4), executive functions (OR 1.8, 95% CI 1.2-7.3), and

reasoning/problem solving (OR 1.9, 95% CI 1.4-7.2) were associated

with unemployment after 3 years.

CONCLUSION: The number of cognitive spheres, and especially attention,

memory, and executive functions, are important factors associated with

unemployment in patients with SLE.

PMID: 19405004

http://www.ncbi.nlm.nih.gov/pubmed/19405004

Not an MD