A large-scale retrospective study found that patients with systemic lupus erythematosus (SLE) may be twice as likely to develop dementia as others of similar age and sex, a finding that may help to improve their care.
The study, “Increased Risk of Dementia in Patients with Systemic Lupus Erythematosus: A Nationwide Population-Based Cohort Study,” was published in the journal Arthritis Care & Research.
People with SLE, an autoimmune disease that affects multiple organs, can also exhibit neurological symptoms in a condition that is known as neuropsychiatric SLE (NPSLE). Cognitive impairment in planning, attention, execution, and working memory are among the hallmarks of NPSLE, which, as with all dementia, can have a major impact on a person’s quality of life.
Neurological symptoms commonly begin to be evident shortly after diagnosis, and are similar to those of dementia patients. The association between SLE and dementia risk, however, is not clear.
Researchers evaluated the incidence of dementia in a cohort of 1,074 SLE patients, compared with a control group of 5,370 age- and sex-matched people without SLE. All participants were followed for up to seven years, until a dementia diagnosis or the December 2010 close of the study.
Results showed that for every 100,000 patients diagnosed with SLE per year, 357 developed dementia. These values were higher than in the control group, where 180 cases per 100,000 person-year were diagnosed with dementia. Overall, SLE patients had a 2.14 times increased risk of developing dementia compared to those without SLE.
“Our study first demonstrated that patients with systemic lupus erythematosus (SLE) have higher risk of developing dementia than non-SLE patients,” the researchers wrote.
According to the team, the complex reasons behind this finding are not fully understood, but may in part be explained by the involvement of the central nervous system. Identifying these factors in future work may help to prevent dementia in SLE patients.
Among the likely SLE-related factors linked to NPSLE are an increased risk of stroke, structural cerebral abnormalities, and exacerbated autoimmunity, the researchers said. More studies on the underling mechanism of mental disorders associated to diseases of the nervous system and SLE are required.
Nonetheless, the study highlights the importance of applying dementia prevention strategies to the clinic care of SLE patients to improve their quality of life.