Fluid Cognition among Individuals with Systemic Lupus Erythematosus.

OBJECTIVE: We sought to describe fluid cognition and its correlates among individuals with SLE.

METHODS: Participants (n=199) were recruited from a population-based cohort for a single study visit (10/2019-5/2022). Fluid cognition was measured via the NIH Toolbox Fluid Cognition Battery (including episodic memory, working memory, attention and inhibitory control, processing speed, and cognitive flexibility domains) and expressed as age-corrected standard scores (mean=100; SD=15). Potential impairment was defined as a standard score >1.5 SD below the mean. Descriptive statistics were calculated and associations of various participant characteristics with the potential fluid cognition impairment were assessed with multivariable logistic regression.

RESULTS: Participants' mean age was 46.1 years; most were female (87.4%), Black (86.4%), and non-Hispanic (95.0%). The mean overall fluid cognition score was 87.2; of the individual domains, participants' mean score was lowest on attention and inhibitory control (82.0). Working status [OR=0.30 (95% CI, 0.14-0.64)] and higher self-reported physical functioning [OR=0.46 (95% CI, 0.28-0.75)] and physical performance [OR=0.72 (95% CI 0.59-0.87)] were associated with lower odds of fluid cognition impairment; lower educational attainment was associated with higher odds [OR=3.82 (95% CI, 1.67-8.75)]. Self-reported forgetfulness, neuropsychiatric damage, and depressive symptoms were not statistically significantly associated with potential impairment.

CONCLUSION: Fluid cognition and, particularly, attention and inhibitory control were low in those with SLE relative to the general U.S.

POPULATION: Working status, higher physical functioning and performance, and higher educational attainment were associated with lower prevalence of potential impairment. Future work is needed to develop and implement interventions to help support cognition in SLE.