Calderón J, Flores P, Aguirre J M, Valdivia G, Padilla O, Barra I, Scoriels L, Herrera S, González A, Massardo L
a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
Scand J Rheumatol. 2017 Jul;46(4):273-280. doi: 10.1080/03009742.2016.1206617. Epub 2016 Oct 5.
To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients.
We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function.
All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL.
Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.
明确认知障碍、抑郁、疾病活动度及疾病损害在系统性红斑狼疮（SLE）患者中常见的健康相关生活质量（HRQoL）下降中所起的相对作用。
我们研究了101名智利女性SLE患者，并应用12项医疗结局研究（MOS）简短健康调查第2版（SF - 12v2）评估HRQoL，应用剑桥神经心理测试自动成套系统（CANTAB）评估认知功能。协方差分析（ANCOVA）模型纳入了人口统计学和疾病相关因素以及持续注意力、记忆力和执行功能的认知功能测试。
与智利普通人群中的女性相比，101名女性SLE患者的所有HRQoL指标均较低。HRQoL与以下因素相关：（i）抑郁症状，对身心健康HRQoL评分的所有组成部分均有不利影响；（ii）执行功能障碍（空间规划），与因身体健康问题和情绪问题导致的角色限制得分较低以及总体健康感知相关；（iii）较高的疾病活动度和器官损害对角色身体功能、身体疼痛和身体综合评分有害；（iv）较高的损害也影响身体功能。持续注意力和记忆力受损并未降低HRQoL。
我们的结果突出了执行功能障碍与SLE患者HRQoL中身心健康不佳组成部分以及抑郁的相关性，而疾病活动度和疾病损害与较低的HRQoL身体组成部分相关。这表明SLE患者需要进行认知功能评估和康复。
