Lupus

ObjectiveTo examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE).MethodsAmong 777 adult (>18 years) SLE patients, we examined the association of Perceived Stress Scale (PSS) scores with two self-reported cognitive symptoms: 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). We used multivariable logistic regression to estimate the odds ratios (ORs) per minimal important difference (MID=0.5*SD) of PSS score and cognitive symptoms.ResultsForgetfulness 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\u20131.47) and difficulty concentrating (OR=2.19, 95% CI 1.90\u20132.52). No substantial differences in this association by age, race, sex, or disease activity were noted.ConclusionsSLE patients, particularly those with high disease activity, report a high burden of cognitive symptoms, for which stress may be a modifiable risk factor.R01 AR065493/AR/NIAMS NIH HHSUnited States/U01DP005119/ACL/ACL HHSUnited States/UL1 TR000454/TR/NCATS NIH HHSUnited States/U01 DP006488/DP/NCCDPHP CDC HHSUnited States/U01 DP005119/DP/NCCDPHP CDC HHSUnited States