Performance of Screening Tests for Cognitive Impairment in Systemic Lupus Erythematosus

Nantes, Stephanie G.; Su, Jiandong; Dhaliwal, Ashneet; Colosimo, Kenneth; Touma, Zahi

doi:10.3899/jrheum.161125

Cited by 54 publications

(64 citation statements)

References 30 publications

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“…In our study, the MoCA test was the screening instrument that identifie the largest number of patients with cognitive impairment, followed by the MMSE and CSI, similar to the findings of previous reports. 10 , 21 – 23 In addition, the three instruments correlated with the gold standard neuropsychological battery findings, in the same order (MoCA > MMSE > CSI), providing concurrent validity. Our study is robust, as the application of all three screening tools for assessing cognitive impairment as compared to the gold standard has not been reported previously.…”

Section: Discussionmentioning

confidence: 78%

“…Nantes et al conducted a study in 98 patients with SLE, in which the MoCA and MMSE were compared against the Hopkins Verbal Learning Test-Revised. 10 The MoCA test showed the highest sensitivity, while the MMSE presented highest specificity. In our study, the highest sensitivity and specificity were obtained with the MoCA test.…”

Section: Discussionmentioning

confidence: 94%

“…Such differences might be due to our use of the gold standard recommended by the cognitive subcommittee of the ACR. 7 , 10 …”

Section: Discussionmentioning

confidence: 99%

“…The neuropsychological battery (gold standard) is time-consuming to implement. 7 , 10 , 12 Consequently, we considered it necessary to evaluate the use of other screening tools in comparison with the neuropsychological battery. The aim of our study was therefore to evaluate and compare the efficacy of three screening tests for cognitive impairment (the Mini Mental State Examination [MMSE], 13 , 14 the Montreal Cognitive Assessment [MoCA], 15 , 16 and the Cognitive Symptom Inventory [CSI] 17 ) against the gold standard 7 , 12 to identify the most efficient screening test, in patients with SLE.…”

mentioning

confidence: 99%

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The Montreal Cognitive Assessment Test

Paez-Venegas¹,

Jordan-Estrada²,

Chavarria-Ávila³

et al. 2018

J Clin Rheumatol

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The MoCA is a brief, easily applied screening test that is highly effective for detecting cognitive impairment in SLE patients. It could be useful in clinical follow-up as a tool for early detection of cognitive alterations.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial -No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 94%

“…Such differences might be due to our use of the gold standard recommended by the cognitive subcommittee of the ACR. 7 , 10 …”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The Montreal Cognitive Assessment Test

Paez-Venegas¹,

Jordan-Estrada²,

Chavarria-Ávila³

et al. 2018

J Clin Rheumatol

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“…We read with great interest the paper on performance of screening tests for cognitive impairment (CI) in systemic lupus erythematosus (SLE), by Nantes, et al 1 . They indicated that CI is highly prevalent in SLE, and that the Montreal Cognitive Assessment (MoCA) is a good tool to screen early CI.…”

Section: Montreal Cognitive Assessment and Magnetic Resonance Imagingmentioning

confidence: 99%

Montreal Cognitive Assessment and Magnetic Resonance Imaging Identify Cognitive Impairment in Young Patients with Neuropsychiatric Systemic Lupus Erythematosus

Chang

2019

J Rheumatol

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Validity Evidence for the Use of Automated Neuropsychologic Assessment Metrics As a Screening Tool for Cognitive Impairment in Systemic Lupus Erythematosus

Tayer-Shifman

Green

Beaton

et al. 2020

Arthritis Care & Research

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Objective. Screening for cognitive impairment in systemic lupus erythematosus (SLE) conventionally relies on the American College of Rheumatology (ACR) neuropsychologic battery (NB), which is not universally available. To develop a more accessible screening approach, we assessed validity of the Automated Neuropsychological Assessment Metrics (ANAM). Using the ACR NB as the gold standard for cognitive impairment classification, the objectives were 1) to measure overall discriminative validity of the ANAM for cognitive impairment versus no cognitive impairment, 2) to identify ANAM subtests and scores that best differentiate patients with cognitive impairment from those with no cognitive impairment, and 3) to derive ANAM composite indices and cutoffs. Methods. A total of 211 consecutive adult patients, female and male, with SLE were administered the ANAM and ACR NB. 1) For overall discriminative validity of the ANAM, we compared patients with cognitive impairment versus those with no cognitive impairment on 4 scores. 2) Six ANAM models using different scores were developed, and the most discriminatory subtests were selected using logistic regression analyses. The area under the receiver operating characteristic curve (AUC) was calculated to establish ANAM validity against the ACR NB. 3) ANAM composite indices and cutoffs were derived for the best models, and sensitivities and specificities were calculated. Results. Patients with no cognitive impairment performed better on most ANAM subtests, supporting ANAM's discriminative validity. Cognitive impairment could be accurately identified by selected ANAM subtests with top models, demonstrating excellent AUCs of 81% and 84%. Derived composite indices and cutoffs demonstrated sensitivity of 78-80% and specificity of 70%. Conclusion. This study provides support for ANAM's discriminative validity for cognitive impairment and utility for cognitive screening in adult SLE. Derived composite indices and cutoffs enhance clinical applicability.

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Performance of Screening Tests for Cognitive Impairment in Systemic Lupus Erythematosus

Abstract: CI is highly prevalent and MoCA may be a useful tool to screen for CI in SLE. Patients with more years of education were less likely to have CI.

Cited by 54 publications

References 30 publications

The Montreal Cognitive Assessment Test

The Montreal Cognitive Assessment Test

Montreal Cognitive Assessment and Magnetic Resonance Imaging Identify Cognitive Impairment in Young Patients with Neuropsychiatric Systemic Lupus Erythematosus

Validity Evidence for the Use of Automated Neuropsychologic Assessment Metrics As a Screening Tool for Cognitive Impairment in Systemic Lupus Erythematosus

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