title: Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: J
authors.initials: J
authors.lastname: Calderón
authors.affiliation: a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: P
authors.initials: P
authors.lastname: Flores
authors.affiliation: a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: J M
authors.initials: JM
authors.lastname: Aguirre
authors.affiliation: b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: G
authors.initials: G
authors.lastname: Valdivia
authors.affiliation: b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: O
authors.initials: O
authors.lastname: Padilla
authors.affiliation: c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: I
authors.initials: I
authors.lastname: Barra
authors.affiliation: d Institute of Biomedical Sciences , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Scoriels
authors.affiliation: c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: S
authors.initials: S
authors.lastname: Herrera
authors.affiliation: e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.|f Centre for Ageing and Regeneration (CARE), Department of Molecular and Cell Biology, Faculty of Biological Sciences , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: A
authors.initials: A
authors.lastname: González
authors.affiliation: e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.
authors.forename: L
authors.initials: L
authors.lastname: Massardo
mesh_terms: D000328:Adult; D001288:Attention; D016022:Case-Control Studies; D002677:Chile; D060825:Cognitive Dysfunction / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006304:Health Status; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014930:Women / Q000523:psychology*