Cognitive impairment and employment status in systemic lupus erythematosus: A prospective longitudinal study
Objective To determine the relationship between cognitive impairment and employment in patients with systemic lupus erythematosus (SLE). Methods A total of 167 consecutive patients with SLE were prospectively evaluated, and underwent standardized neuropsychological tests. Multivariate logistic regre...
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| Veröffentlicht in: | Arthritis and rheumatism 2009-05, Vol.61 (5), p.680-687 |
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| creator | Appenzeller, Simone Cendes, Fernando Costallat, Lilian T. L. |
| description | Objective
To determine the relationship between cognitive impairment and employment in patients with systemic lupus erythematosus (SLE).
Methods
A total of 167 consecutive patients with SLE were prospectively evaluated, and underwent standardized neuropsychological tests. Multivariate logistic regression was used to determine the likelihood of being unemployed, adjusting for sociodemographic characteristics, employment status at study entry, disease activity, disease duration, damage scores, and depression.
Results
At study entry, 118 (70.7%) of 167 patients were employed. In the multivariate analysis, after adjusting for confounders, unemployment was predicted by the number of cognitive domains impaired (odds ratio [OR] 1.76, 95% confidence interval [95% CI] 1.58–6.72), depression (OR 1.3, 95% CI 1.1–3.1), fewer years of education (OR 0.12, 95% CI 0.02–0.34), and the presence of anticardiolipin antibodies (OR 1.43, 95% CI 1.2–6.1). Complex attention (OR 1.7, 95% CI 1.2–3.6), memory (OR 3.1, 95% CI 1.5–6.2), and executive functions (OR 2.4, 95% CI 1.9–6.1) were predictors of unemployment at study entry. After 3 years, 61 (51.7%) of 118 patients were employed (OR 2.25, 95% CI 1.38–3.68; P = 0.001). The likelihood of being unemployed after 3 years was predicted by the number of cognitive domains impaired (OR 3.8, 95% CI 2.5–7.71), depression (OR 2.31, 95% CI 1.01–5.21), fewer years of education (OR 0.09, 95% CI 0.01–0.42), and the presence of anticardiolipin antibodies (OR 2.1, 95% CI 1.2–4.9). Complex attention (OR 2.2, 95% CI 1.1–3.8), memory (OR 3.6, 95% CI 2.1–6.4), executive functions (OR 1.8, 95% CI 1.2–7.3), and reasoning/problem solving (OR 1.9, 95% CI 1.4–7.2) were associated with unemployment after 3 years.
Conclusion
The number of cognitive spheres, and especially attention, memory, and executive functions, are important factors associated with unemployment in patients with SLE. |
| doi_str_mv | 10.1002/art.24346 |
| format | Article |
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To determine the relationship between cognitive impairment and employment in patients with systemic lupus erythematosus (SLE).
Methods
A total of 167 consecutive patients with SLE were prospectively evaluated, and underwent standardized neuropsychological tests. Multivariate logistic regression was used to determine the likelihood of being unemployed, adjusting for sociodemographic characteristics, employment status at study entry, disease activity, disease duration, damage scores, and depression.
Results
At study entry, 118 (70.7%) of 167 patients were employed. In the multivariate analysis, after adjusting for confounders, unemployment was predicted by the number of cognitive domains impaired (odds ratio [OR] 1.76, 95% confidence interval [95% CI] 1.58–6.72), depression (OR 1.3, 95% CI 1.1–3.1), fewer years of education (OR 0.12, 95% CI 0.02–0.34), and the presence of anticardiolipin antibodies (OR 1.43, 95% CI 1.2–6.1). Complex attention (OR 1.7, 95% CI 1.2–3.6), memory (OR 3.1, 95% CI 1.5–6.2), and executive functions (OR 2.4, 95% CI 1.9–6.1) were predictors of unemployment at study entry. After 3 years, 61 (51.7%) of 118 patients were employed (OR 2.25, 95% CI 1.38–3.68; P = 0.001). The likelihood of being unemployed after 3 years was predicted by the number of cognitive domains impaired (OR 3.8, 95% CI 2.5–7.71), depression (OR 2.31, 95% CI 1.01–5.21), fewer years of education (OR 0.09, 95% CI 0.01–0.42), and the presence of anticardiolipin antibodies (OR 2.1, 95% CI 1.2–4.9). Complex attention (OR 2.2, 95% CI 1.1–3.8), memory (OR 3.6, 95% CI 2.1–6.4), executive functions (OR 1.8, 95% CI 1.2–7.3), and reasoning/problem solving (OR 1.9, 95% CI 1.4–7.2) were associated with unemployment after 3 years.
Conclusion
The number of cognitive spheres, and especially attention, memory, and executive functions, are important factors associated with unemployment in patients with SLE.</description><identifier>ISSN: 0004-3591</identifier><identifier>ISSN: 0893-7524</identifier><identifier>EISSN: 1529-0131</identifier><identifier>EISSN: 1529-0123</identifier><identifier>DOI: 10.1002/art.24346</identifier><identifier>PMID: 19405004</identifier><identifier>CODEN: ARCREG</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Adult ; Antibodies, Anticardiolipin - blood ; Attention ; Biological and medical sciences ; Cognition Disorders - psychology ; Depression - psychology ; Diseases of the osteoarticular system ; Employment - psychology ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Longitudinal Studies ; Lupus Erythematosus, Systemic - blood ; Lupus Erythematosus, Systemic - psychology ; Male ; Medical sciences ; Memory ; Middle Aged ; Multivariate Analysis ; Neuropsychological Tests ; Prospective Studies ; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis ; Young Adult</subject><ispartof>Arthritis and rheumatism, 2009-05, Vol.61 (5), p.680-687</ispartof><rights>Copyright © 2009 by the American College of Rheumatology</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4506-9eb9463d915b7b59d20883444dd8f7c8fbafe19ab0958ae2a62d4c682b9c07ea3</citedby><cites>FETCH-LOGICAL-c4506-9eb9463d915b7b59d20883444dd8f7c8fbafe19ab0958ae2a62d4c682b9c07ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.24346$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.24346$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27911,27912,45561,45562</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21465093$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19405004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Appenzeller, Simone</creatorcontrib><creatorcontrib>Cendes, Fernando</creatorcontrib><creatorcontrib>Costallat, Lilian T. L.</creatorcontrib><title>Cognitive impairment and employment status in systemic lupus erythematosus: A prospective longitudinal study</title><title>Arthritis and rheumatism</title><addtitle>Arthritis Rheum</addtitle><description>Objective
To determine the relationship between cognitive impairment and employment in patients with systemic lupus erythematosus (SLE).
Methods
A total of 167 consecutive patients with SLE were prospectively evaluated, and underwent standardized neuropsychological tests. Multivariate logistic regression was used to determine the likelihood of being unemployed, adjusting for sociodemographic characteristics, employment status at study entry, disease activity, disease duration, damage scores, and depression.
Results
At study entry, 118 (70.7%) of 167 patients were employed. In the multivariate analysis, after adjusting for confounders, unemployment was predicted by the number of cognitive domains impaired (odds ratio [OR] 1.76, 95% confidence interval [95% CI] 1.58–6.72), depression (OR 1.3, 95% CI 1.1–3.1), fewer years of education (OR 0.12, 95% CI 0.02–0.34), and the presence of anticardiolipin antibodies (OR 1.43, 95% CI 1.2–6.1). Complex attention (OR 1.7, 95% CI 1.2–3.6), memory (OR 3.1, 95% CI 1.5–6.2), and executive functions (OR 2.4, 95% CI 1.9–6.1) were predictors of unemployment at study entry. After 3 years, 61 (51.7%) of 118 patients were employed (OR 2.25, 95% CI 1.38–3.68; P = 0.001). The likelihood of being unemployed after 3 years was predicted by the number of cognitive domains impaired (OR 3.8, 95% CI 2.5–7.71), depression (OR 2.31, 95% CI 1.01–5.21), fewer years of education (OR 0.09, 95% CI 0.01–0.42), and the presence of anticardiolipin antibodies (OR 2.1, 95% CI 1.2–4.9). Complex attention (OR 2.2, 95% CI 1.1–3.8), memory (OR 3.6, 95% CI 2.1–6.4), executive functions (OR 1.8, 95% CI 1.2–7.3), and reasoning/problem solving (OR 1.9, 95% CI 1.4–7.2) were associated with unemployment after 3 years.
Conclusion
The number of cognitive spheres, and especially attention, memory, and executive functions, are important factors associated with unemployment in patients with SLE.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Antibodies, Anticardiolipin - blood</subject><subject>Attention</subject><subject>Biological and medical sciences</subject><subject>Cognition Disorders - psychology</subject><subject>Depression - psychology</subject><subject>Diseases of the osteoarticular system</subject><subject>Employment - psychology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Longitudinal Studies</subject><subject>Lupus Erythematosus, Systemic - blood</subject><subject>Lupus Erythematosus, Systemic - psychology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Memory</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neuropsychological Tests</subject><subject>Prospective Studies</subject><subject>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</subject><subject>Young Adult</subject><issn>0004-3591</issn><issn>0893-7524</issn><issn>1529-0131</issn><issn>1529-0123</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0U1r3DAQBmBRWppN2kP_QPClhRyc6NtWbsvSJIVAoaRnM5bGqYL8EUtu8b-vurs0p9KTGOnhHUlDyAdGLxml_ArmdMmlkPoV2TDFTUmZYK_JhlIqS6EMOyGnMT7lkgsl3pITZiRV-XBDwm58HHzyP7Hw_QR-7nFIBQyuwH4K47ovY4K0xMIPRVxjwt7bIixT3sF5TT-whzTGJV4X22Kaxzih3eeFcXj0aXF-gJAjFre-I286CBHfH9cz8v3m88Purrz_evtlt70vrVRUlwZbI7Vwhqm2apVxnNa1kFI6V3eVrbsWOmQGWmpUDchBcyetrnlrLK0QxBn5dMjN13leMKam99FiCDDguMRGV1xWWvH_Qk61kIabDC8O0OYHxhm7Zpp9D_PaMNr8mUGTZ9DsZ5Dt-TF0aXt0L_L46Rl8PAKIFkI3w2B9_Os4k1pRI7K7OrhfPuD6747N9tvDofVveLKgFg</recordid><startdate>20090515</startdate><enddate>20090515</enddate><creator>Appenzeller, Simone</creator><creator>Cendes, Fernando</creator><creator>Costallat, Lilian T. L.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>20090515</creationdate><title>Cognitive impairment and employment status in systemic lupus erythematosus: A prospective longitudinal study</title><author>Appenzeller, Simone ; Cendes, Fernando ; Costallat, Lilian T. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4506-9eb9463d915b7b59d20883444dd8f7c8fbafe19ab0958ae2a62d4c682b9c07ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Antibodies, Anticardiolipin - blood</topic><topic>Attention</topic><topic>Biological and medical sciences</topic><topic>Cognition Disorders - psychology</topic><topic>Depression - psychology</topic><topic>Diseases of the osteoarticular system</topic><topic>Employment - psychology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Longitudinal Studies</topic><topic>Lupus Erythematosus, Systemic - blood</topic><topic>Lupus Erythematosus, Systemic - psychology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Memory</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neuropsychological Tests</topic><topic>Prospective Studies</topic><topic>Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Appenzeller, Simone</creatorcontrib><creatorcontrib>Cendes, Fernando</creatorcontrib><creatorcontrib>Costallat, Lilian T. L.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis and rheumatism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Appenzeller, Simone</au><au>Cendes, Fernando</au><au>Costallat, Lilian T. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cognitive impairment and employment status in systemic lupus erythematosus: A prospective longitudinal study</atitle><jtitle>Arthritis and rheumatism</jtitle><addtitle>Arthritis Rheum</addtitle><date>2009-05-15</date><risdate>2009</risdate><volume>61</volume><issue>5</issue><spage>680</spage><epage>687</epage><pages>680-687</pages><issn>0004-3591</issn><issn>0893-7524</issn><eissn>1529-0131</eissn><eissn>1529-0123</eissn><coden>ARCREG</coden><abstract>Objective
To determine the relationship between cognitive impairment and employment in patients with systemic lupus erythematosus (SLE).
Methods
A total of 167 consecutive patients with SLE were prospectively evaluated, and underwent standardized neuropsychological tests. Multivariate logistic regression was used to determine the likelihood of being unemployed, adjusting for sociodemographic characteristics, employment status at study entry, disease activity, disease duration, damage scores, and depression.
Results
At study entry, 118 (70.7%) of 167 patients were employed. In the multivariate analysis, after adjusting for confounders, unemployment was predicted by the number of cognitive domains impaired (odds ratio [OR] 1.76, 95% confidence interval [95% CI] 1.58–6.72), depression (OR 1.3, 95% CI 1.1–3.1), fewer years of education (OR 0.12, 95% CI 0.02–0.34), and the presence of anticardiolipin antibodies (OR 1.43, 95% CI 1.2–6.1). Complex attention (OR 1.7, 95% CI 1.2–3.6), memory (OR 3.1, 95% CI 1.5–6.2), and executive functions (OR 2.4, 95% CI 1.9–6.1) were predictors of unemployment at study entry. After 3 years, 61 (51.7%) of 118 patients were employed (OR 2.25, 95% CI 1.38–3.68; P = 0.001). The likelihood of being unemployed after 3 years was predicted by the number of cognitive domains impaired (OR 3.8, 95% CI 2.5–7.71), depression (OR 2.31, 95% CI 1.01–5.21), fewer years of education (OR 0.09, 95% CI 0.01–0.42), and the presence of anticardiolipin antibodies (OR 2.1, 95% CI 1.2–4.9). Complex attention (OR 2.2, 95% CI 1.1–3.8), memory (OR 3.6, 95% CI 2.1–6.4), executive functions (OR 1.8, 95% CI 1.2–7.3), and reasoning/problem solving (OR 1.9, 95% CI 1.4–7.2) were associated with unemployment after 3 years.
Conclusion
The number of cognitive spheres, and especially attention, memory, and executive functions, are important factors associated with unemployment in patients with SLE.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>19405004</pmid><doi>10.1002/art.24346</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Antibodies, Anticardiolipin - blood Attention Biological and medical sciences Cognition Disorders - psychology Depression - psychology Diseases of the osteoarticular system Employment - psychology Female Follow-Up Studies Humans Logistic Models Longitudinal Studies Lupus Erythematosus, Systemic - blood Lupus Erythematosus, Systemic - psychology Male Medical sciences Memory Middle Aged Multivariate Analysis Neuropsychological Tests Prospective Studies Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Young Adult |
| title | Cognitive impairment and employment status in systemic lupus erythematosus: A prospective longitudinal study |
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