Geriatric Assessment of Physical and Cognitive Functioning in a Diverse Cohort of Systemic Lupus Erythematosus Patients: A Pilot Study
Geriatric Assessment of Physical and Cognitive Functioning in a Diverse Cohort of Systemic Lupus Erythematosus Patients: A Pilot Study
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DOI：
10.1002/acr.23507
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发表时间：
2018-10-01
影响因子：
4.7
通讯作者：
Drenkard, Cristina
中科院分区：
文献类型：
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作者：
Plantinga, Laura;Tift, Benjamin D.;Drenkard, Cristina
目的采用多领域功能评估，这是常见的老年患者，但在系统性红斑狼疮（SLE）患者中是新的，以更好地了解SLE患者的功能损害。（年龄20-39岁[26.7%]、40-59岁[50.0%]和60岁[23.3%]; 80.0%为非洲裔美国人，90.0%为女性）。在亲自访问期间（从2016年10月到2017年4月），我们评估了物理性能，（范围0-4，分数越高表示表现越好），认知表现（5）流体认知领域;调整后的T评分）和自我报告的测量，包括身体功能结果SLE患者的平均平衡评分（T评分）、日常生活活动能力（ADL）、福尔斯和生活空间活动能力（LSS）均高于正常对照组（P < 0. 05），差异有显著性（P < 0. 05）。平均下肢力量评分低（1.8）。与相同年龄、性别、种族、民族和教育水平的健康个体相比，情景记忆（47.7）和工作记忆（48.6）的认知表现为平均值（5.0分），认知灵活性（43.7）、处理速度（42.6）和注意力/抑制控制（38.8 [低于平均值>1 SD]）的平均值较低。大多数参与者报告能够独立执行基本的ADL，但许多人报告无法独立执行工具性ADL。近一半（45.0%）的参与者报告在前一年跌倒。只有40.0%的人报告说，他们有无限的能力在没有他人帮助的情况下旅行。分数一般没有显着差异，根据age.ConclusionOur结果表明，在所有年龄的SLE患者的多个领域的功能障碍的患病率很高，类似或超过在更年长的老年人群中观察到的患病率。进一步研究老年评估在SLE常规护理中的附加值是必要的。
ObjectiveTo use multidomain functional assessment, which is commonly performed in geriatric patients but is novel in patients with systemic lupus erythematosus (SLE), to better understand functional impairment in patients with SLE.MethodsWe recruited 60 adult participants (aged 20-39 years [26.7%], 40-59 years [50.0%], and 60 years [23.3%]; 80.0% African American and 90.0% female) from an existing cohort of SLE patients. During in-person visits (from October 2016 to April 2017), we evaluated physical performance (range 0-4, with higher scores indicating better performance), cognitive performance (5 fluid cognition domains; adjusted T scores), and self-reported measures including physical functioning (T scores), activities of daily living (ADLs), falls, and life-space mobility.ResultsIn the SLE patients, the mean balance score (3.7) and gait speed score (3.4) were high, while themean lower body strength score was low (1.8). Cognitive performance was average (score of 5.0) for episodic (47.7) and working (48.6) memory and low average for cognitive flexibility (43.7), processing speed (42.6), and attention/inhibitory control (38.8 [>1 SD below average]) when compared with healthy individuals of the same age, sex, race, ethnicity, and education level. Most participants reported the ability to independently perform basic ADLs, but many reported the inability to independently perform instrumental ADLs. Nearly half (45.0%) of participants reported falling in the prior year. Only 40.0% reported unlimited ability to travel without the help of another person. Scores generally did not differ substantially according to age.ConclusionOur results suggest a high prevalence of impairment across multiple domains of function in SLE patients of all ages, similar to or exceeding the prevalence observed in much older geriatric populations. Further research into the added value of geriatric assessment in routine care for SLE is warranted.