Pos0730 Self-Reported Cognitive Function in Among Older Adults With Systemic Lupus Erythematosus Compared to Other Rheumatic and Musculoskeletal Conditions

Background: Cognitive symptoms such as forgetfulness or "brain fog" are frequently reported by individuals with systemic lupus erythematosus (SLE) and are reported to be among the most distressing symptoms of lupus. Less well understood is how these self-reported symptoms compared to those experienced by individuals with other rheumatic or musculoskeletal conditions and what the relationship of cognitive symptoms may be to disease status. Cognitive symptoms are also more commonly reported among older adults, but little information is available about cognitive symptoms in older people with SLE compare to those of similar ages with other rheumatic or musculoskeletal conditions. Objectives: We examined self-reported cognitive function among an older cohort of individuals with SLE to individuals with rheumatoid arthritis (RA), osteoarthritis (OA), and fibromyalgia (FM) of similar ages, and the association of cognitive function with self-perceptions of disease status and satisfaction with health. Methods: Data were drawn from FORWARD, The National Databank for Rheumatic Diseases, a longitudinal observational cohort. Data are collected biannually via questionnaires. Cognitive symptoms were assessed with the 8-item NeuroQoL Cognitive Function Short Form (NCF)¹. NCF items query cognitive symptoms and perceived ability to complete everyday tasks. Raw scores range from 8-40 and can be transformed to standardized T-scores with a population mean of 50 and standard deviation of 10. The NCF was administered in 3 biannual surveys. We compared scores of individuals with physician-confirmed SLE and no other rheumatic diagnosis to individuals with RA, OA, FM, and SLE + FM using generalized estimating equation (GEE) modeling, adjusting for age, education, pain, fatigue, sleep disturbance, and depressive symptoms. Among the SLE-only group, we compared self-reported lupus disease activity (0-10 scale, 0 = not at all active, 10 = extremely active), organ damage (using the validated Brief Index of Lupus Damage, BILD), and the occurrence of flares in the past 3 months between those with low NCF T-scores (below 40, i.e., 1 SD below mean) and those with higher scores. We also compared health satisfaction (rated on 5-point Likert scale, 0 = very satisfied, 4 = very dissatisfied; low scores = more satisfaction) for those with and without low NCF scores, in both unadjusted t-tests and multivariable regression analysis adjusting for age, education, pain, fatigue, sleep disturbance, depressive symptoms, self-rated lupus activity, and BILD. Results: 142 SLE, 6742 RA, 1018 OA, 298 FM, and 42 SLE+FM questionnaires were completed over 3 periods. Characteristics of each group are shown in Table 1. After adjustment, NCF scores of individuals with SLE alone and SLE +FM were significantly lower than other groups (Table 1). Over a quarter of the SLE group had low NCF scores; almost half of the SLE + FM had low NCF scores (Table 1). Low NCF scores were associated with significantly higher self-reported disease activity and damage, and a greater occurrence of recent flares (Table 2). Health satisfaction was significantly lower among individuals with low NCF in both unadjusted analyses (not low: 1.6 ± 1.2; low: 2.2 ± 1.2; p <0.0001) and adjusted analyses (β = 0.92, p=0.0059). Conclusion: Cognitive symptoms are significantly worse among older individuals with SLE compared to individuals of similar age with other rheumatic or musculoskeletal conditions. Worse perceived cognitive function is, in turn, associated with worse self-reported disease status. Perceptions of cognitive function are associated with less satisfaction with health, even after controlling for disease status. Results confirm that the burden of cognitive symptoms continues into older age for individuals with SLE, is significantly greater than for older individuals with other rheumatic/musculoskeletal conditions, and has an important impact on quality of life, above and beyond lupus disease status. REFERENCES: [1] Iverson GL et al. Arch Clin Neuropsychol 2021; 36:126-134. Acknowledgements: NIL. Disclosure of Interests: None declared.