Lupus Patients Much More Likely to Develop Dementia, Study Suggests

Patients with systemic lupus erythematosus (SLE) show significantly higher rates for dementia compared to healthy people, according to a large cross-sectional Israeli study.

The research, “High proportions of dementia among SLE patients: A big data analysis,” was published in the journal International Journal of Geriatric Psychiatry.

Lupus has a wide clinical spectrum. Sometimes, the disease affects the central nervous system, leading to what is known as neuropsychiatric lupus. But even those patients who do not develop neuropsychiatric manifestations exhibit cognitive decline early on.

Authors of this study investigated a possible link between lupus and dementia. They performed a retrospective cross-sectional study using the largest database in Israel – the Clalit Health Care database – which contains data from more than 4.4 million people.

They identified lupus patients and compared them to a randomly-selected control group from the Clalit Health Care database. Five so-called “control” patients were randomly selected for each lupus patient and researchers compared the rate of dementia in each group.

In total, 4,886 lupus patients and 24 430 age‐ and sex‐ matched controls were included in the analysis. The proportion of dementia was higher in lupus than control patients, researchers found. In fact, lupus patients had three times higher rates of dementia compared to controls – 1.56% versus 0.51%.

The finding was consistent across age groups, with lupus patients always having higher rates of dementia.

Also, lupus patients had more cardiovascular risk factors, such as high blood pressure and high fat content, and had a history of more cerebro-vascular events than controls.

Additional analysis revealed that high blood pressure, high fat content and lupus were all independent risk factors for dementia, with lupus patients being 51 percent more likely to develop dementia in their lifetime than control patients.

“We advocate that there is a need to search for SLE in patients with an ambiguous cause for dementia, especially those with an early onset cognitive decline as well as to inspect for cognitive decline in known lupus patients,” authors wrote.

Overall, “our study implies an association of SLE and dementia, starting at a young age. Caregivers treating young SLE patients should be aware of such an association and seek for reversible causes contributing to these conditions,” the study concluded.