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Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views.

Publication ,  Journal Article
Vandenberg, AE; Drenkard, C; Goldstein, FC; Dunlop-Thomas, C; Lim, SS; Bowling, CB; Plantinga, LC
Published in: Arthritis Care Res (Hoboken)
September 2022

OBJECTIVE: Systemic lupus erythematosus (SLE) is a complex chronic disease associated with reduced cognitive functioning. Patients with SLE report cognitive symptoms, but cognitive assessment is not routine in SLE and little is known about day-to-day cognitive problems and their effect on disease management. As part of a pilot exploring the use of a cognitive functioning report prototype for shared decision-making in clinical encounters (the Approaches to Positive Patient-Centered Experiences of Aging in Lupus [APPEAL] Study), we investigated the relevance of cognitive assessments performed using the National Institutes of Health (NIH) Toolbox among patients with SLE. METHODS: We conducted 4 focus groups, 2 with SLE patients (n = 18) and 2 with lupus providers (physicians and nurses; n = 9), addressing cognitive issues and interest in communicating about cognition. We compared how NIH Toolbox cognitive domains (episodic memory, working memory, processing speed, attention and inhibitory control, cognitive flexibility) matched with patient- and provider-identified cognitive problems and needs. RESULTS: Patients identified all NIH domains with rich experiential examples; providers identified fewer domains and offered less detail. An unanticipated additional domain was prospective memory (i.e., problems with remembering future actions). Use of technologic aids (e.g., smart phone alerts) was mentioned by some patients, but not providers, and represent a potential opportunity for medical care. All participants expressed interest in discussing cognition in clinic. CONCLUSION: Cognitive assessment using the NIH Cognitive Toolbox is relevant to this population, with the possible addition of a prospective memory assessment. Cognitive problems and indications of communication gaps suggest the appropriateness of more clinical communication about cognition in the SLE population.

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Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

September 2022

Volume

74

Issue

9

Start / End Page

1468 / 1476

Location

United States

Related Subject Headings

  • Neuropsychological Tests
  • Memory, Short-Term
  • Lupus Erythematosus, Systemic
  • Humans
  • Cognition Disorders
  • Cognition
  • Attention
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1701 Psychology
 

Citation

APA
Chicago
ICMJE
MLA
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Vandenberg, A. E., Drenkard, C., Goldstein, F. C., Dunlop-Thomas, C., Lim, S. S., Bowling, C. B., & Plantinga, L. C. (2022). Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views. Arthritis Care Res (Hoboken), 74(9), 1468–1476. https://doi.org/10.1002/acr.24599
Vandenberg, Ann E., Cristina Drenkard, Felicia C. Goldstein, Charmayne Dunlop-Thomas, S Sam Lim, C Barrett Bowling, and Laura C. Plantinga. “Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views.Arthritis Care Res (Hoboken) 74, no. 9 (September 2022): 1468–76. https://doi.org/10.1002/acr.24599.
Vandenberg AE, Drenkard C, Goldstein FC, Dunlop-Thomas C, Lim SS, Bowling CB, et al. Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views. Arthritis Care Res (Hoboken). 2022 Sep;74(9):1468–76.
Vandenberg, Ann E., et al. “Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views.Arthritis Care Res (Hoboken), vol. 74, no. 9, Sept. 2022, pp. 1468–76. Pubmed, doi:10.1002/acr.24599.
Vandenberg AE, Drenkard C, Goldstein FC, Dunlop-Thomas C, Lim SS, Bowling CB, Plantinga LC. Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views. Arthritis Care Res (Hoboken). 2022 Sep;74(9):1468–1476.
Journal cover image

Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

September 2022

Volume

74

Issue

9

Start / End Page

1468 / 1476

Location

United States

Related Subject Headings

  • Neuropsychological Tests
  • Memory, Short-Term
  • Lupus Erythematosus, Systemic
  • Humans
  • Cognition Disorders
  • Cognition
  • Attention
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1701 Psychology