Abstract Background/Aims Cognitive dysfunction (CD) is a significant and common neuropsychiatric manifestation of systemic lupus erythematosus (SLE) that adversely affects quality of life. This cross-sectional study aimed to estimate the prevalence and quantify the level of CD in an Indian SLE cohort, examine associated factors, and assess correlation with magnetic resonance spectroscopy (MRS) changes and anti-Ribosomal P (anti-P) antibodies. Methods Fifty-two SLE cases (n = 46 analyzed) were recruited from a tertiary center. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the Addenbrooke’s Cognitive Examination III (ACEIII). Brain metabolic changes were evaluated using MRS, and anti-P antibody levels were measured by ELISA. Results The overall prevalence of CD was 41.3% as determined by MoCA , with the majority of subjects presenting with mild impairment. MoCA and ACEIII scores demonstrated strong agreement (rho=0.775, p 0.001), consistently identifying Delayed Recall and Memory as the most affected cognitive domains. Factors significantly associated with CD included lower mean education years (p = 0.008) and a significantly higher mean glucocorticoid dose (p = 0.027). Abnormal MRS findings were observed in 33.3% of tested patients, and the Cho/Cr ratio negatively correlated with the ACEIII total score (p = 0.048). Conclusion Cognitive dysfunction is highly prevalent in this SLE cohort. Lower educational attainment and higher glucocorticoid doses are significant risk factors. Non-invasive tools like MoCA and ACEIII are effective for screening, and MRS is valuable for detecting subtle underlying neuronal changes. Disclosure S.M. Yadav: None. S. Kansurkar: None. V. Bhatt: None. K. Krishna: None.
Yadav et al. (2026) studied this question.