Do subjective cognitive complaints correlate with cognitive impairment in systemic lupus erythematosus? A Danish outpatient study

Abstract

This study examined the prevalence of cognitive impairment and its association with depressive symptoms and self-reported cognitive complaints in Danish outpatients with systemic lupus erythematosus (SLE). Fifty-seven consecutive female SLE-outpatients were examined with a comprehensive neuropsychological test-battery, a 20-item self-administered Perceived Deficits Questionnaire (PDQ) and a self-rated depression scale (Major Depression Inventory). Twenty-two patients (38.5%) were classified as cognitively impaired, mostly with deficits in executive functions and attention. Among cognitively impaired patients only 18.2% had significantly higher PDQ scores than the normal range. PDQ scores were highly correlated to depressive symptoms (r = 0.67, p < 0.001). Only two neuropsychological tests were significantly correlated with subjective cognitive complaints. When these variables and self-rated depression score were entered into a regression model both depression score and Symbol Digit Modalities Test performances were significantly associated with the PDQ score. In conclusion, cognitive impairments were common in this group of (mild) SLE outpatients, but the level of significant subjective cognitive complaints was low even among patients with cognitive impairment. Affective status may influence subjective experience of cognitive functions even more than cognitive functioning itself, and absence of subjective cognitive complaints did not exclude the presence of cognitive impairments.

Validation of the Brief Cognitive Symptoms Index in Sjögren Syndrome

“…Two self-report instruments, the Cognitive Failures Questionnaire (CFQ) and the Perceived Deficits Questionnaire-Short Form (PDQ), have been used in patients with rheumatic disease but neither questionnaire has been validated in patients with SS 41,42,43 . The CFQ was meant to identify lapses in memory, attention, and action 44 .…”

“…Absence of cognitive complaints does not exclude the presence of cognitive problems. Vogel, et al reported in a study of Danish patients with SLE that the level of subjective cognitive complaints was low even among patients with cognitive impairment 41 . If the clinical context warrants, formal neuropsychological evaluation should be considered even in the absence of cognitive complaints.…”

Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury

“…Problems with accuracy in selfreported cognitive symptoms are seen in a variety of health conditions, including cognitive functioning after cancer treatment [1], systemic lupus erythematosus [2], epilepsy [3], multiple sclerosis [4], Parkinson disease (PD) [5], and schizophrenia [6]. This reduced accuracy is generally related to overreporting of symptoms, but varies according to the condition.…”

The Perceived Deficits Questionnaire

“…14,15 Reports on the PDQ have similarly been found to be related to concomitant reports of depression. 15 Moreover, in a recent study examining the PDQ in a population of patients with lupus, who tend to underreport cognitive concerns, Vogel et al 16 observed a high correlation between subjective cognitive concerns as measured by the PDQ and self-rated depressive symptoms. Together, these findings suggest that mean (SD) amount of education was 15.5 (2.47) years (Table 1).…”