Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus

• Type of Material: Article
• Authors: Laura Christine Plantinga, Emory University; S Sam Lim, Emory University; Christopher Bowling, Emory University; Cristina M Drenkard, Emory University
• Language: English
• Date: 2017-09-01
• Publisher: SAGE Publications (UK and US)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © SAGE Publications.
• Final Published Version (URL): http://dx.doi.org/10.1177/0961203317693095
• Title of Journal or Parent Work: Lupus
• ISSN: 0961-2033
• Volume: 26
• Issue: 10
• Start Page: 1064
• End Page: 1071
• Grant/Funding Information: The GOAL study was supported by Human Genome Science Inc. and GlaxoSmithKline (GHO-11-3366). S.S.L. and C.D. are supported by the NIH (R01AR065493) and the CDC (U01DP005119).; This study was supported in part by PHS Grant UL1TR000454 from the Clinical and Translational Science Award Program, National Institutes of Health, National Center for Advancing Translational Sciences.
• Keywords: Systemic lupus erythematosus; BRIEF INDEX; PREVALENCE; HEALTH; Life Sciences & Biomedicine; Rheumatology; MANIFESTATIONS; PERSPECTIVE; QUALITY-OF-LIFE; African-American; VALIDATION; IMPAIRMENT; stress; cognitive function; Science & Technology; DYSFUNCTION; WOMEN
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms was examined: forgetfulness (severe/moderate vs. mild/none; from the Systemic Lupus Activity Questionnaire) and difficulty concentrating (all/most vs. some/little/none of the time; from the Lupus Impact Tracker). The study used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID = 0.5∗SD) of PSS score and cognitive symptoms. Results Forgetfulness and difficulty concentrating were reported by 41.7% and 29.5%, respectively. Women and those with less education and high disease activity had higher PSS scores and were more likely to report cognitive symptoms than their counterparts. With adjustment for age, race, sex, education, and disease activity, each MID increase in PSS score was associated with higher prevalence of forgetfulness (OR = 1.43, 95% CI 1.29-1.47) and difficulty concentrating (OR = 2.19, 95% CI 1.90-2.52). No substantial differences in this association by age, race, sex, or disease activity were noted. Conclusions SLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.