title: Systemic lupus erythematosus impairs memory cognitive tests not affected by depression.
abstract: OBJECTIVE
  Our aim was to assess the contribution of depression to cognitive impairment in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  Clinical features, education, age, and Hospital Anxiety and Depression Scale (HADS) were evaluated in 82 patients with SLE and 22 healthy controls, all Chilean women. The Cambridge Neuropsychological Test Automated Battery (CANTAB eclipseTM) assessing attention, spatial memory, and learning and executive function domains was applied. Cognitive deficit definition: a cut-off for definite impairment was defined as a score below -2 standard deviations in at least one outcome measure in two or more domains. ANCOVA with stepwise selection evaluated influences of health status (SLE or control), age, education, and HADS depression and anxiety scores on cognitive outcomes. To avoid overfitting, a shrinkage method was performed. Also, adjusted p-values for multiple comparisons were obtained.
  
  
  RESULTS
  Cognitive deficit affected 16 (20%) patients, and no controls (p=0.039). Median HADS depression score in SLE patients was 6 (range 0-19) and in controls was 0 (0-19), p<0.001). ANCOVA and shrinkage models showed that worse cognitive performance in sustained attention and spatial working memory tests was explained by the presence of SLE but not depression, whereas depression only affected a measure of executive function (I/ED Stages completed).
  
  
  CONCLUSIONS
  Depression has a limited role in cognitive impairment in SLE. Impairments in sustained attention and spatial working memory are distinctly influenced by yet-unknown disease-intrinsic factors.
authors.affiliation: Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Calderón
authors.affiliation: Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: P
authors.initials: P
authors.lastname: Flores
authors.affiliation: Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: M
authors.initials: M
authors.lastname: Babul
authors.affiliation: Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: J M
authors.initials: JM
authors.lastname: Aguirre
authors.affiliation: Department of Neurological Sciences Oriente, Facultad de Medicina, Universidad de Chile, Chile.
authors.forename: A
authors.initials: A
authors.lastname: Slachevsky
authors.affiliation: Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: O
authors.initials: O
authors.lastname: Padilla
authors.affiliation: Institute of Biomedical Sciences, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Scoriels
authors.affiliation: Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Henríquez
authors.affiliation: Department of Neurology, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Cárcamo
authors.affiliation: Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
authors.forename: M
authors.initials: M
authors.lastname: Bravo-Zehnder
authors.affiliation: Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile Center for Aging and Regeneration, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: A
authors.initials: A
authors.lastname: González
authors.affiliation: Department of Clinical Immunology and Rheumatology, School of Medicine, Pontificia Universidad Católica de Chile, Chile masssardo@med.puc.cl agonzara@med.puc.cl.
authors.forename: L
authors.initials: L
authors.lastname: Massardo
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002677:Chile; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis / Q000523:psychology*; D008570:Memory, Short-Term; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D012307:Risk Factors; D065852:Spatial Memory; D055815:Young Adult
keywords: Neuropsychiatric lupus; cognitive; depression; dysfunction; systemic lupus erythematosus