Perceived cognitive dysfunction more likely in patients with SSc who have greater fatigue
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Among patients with systemic sclerosis, those on work disability and who experience greater levels of fatigue are more likely to perceive cognitive dysfunction, according to data published in Arthritis Care & Research.
“Clearly identifying potential factors and symptoms associated with perceived cognitive dysfunction in patients with SSc could enable adequate strategies to manage or reduce this problem,” Yen T. Chen, PhD, of the department of physical medicine and rehabilitation at the University of Michigan, in Ann Arbor, and colleagues wrote. “Due to high symptom burden in patients who have SSc, perceptions of cognitive dysfunction might be driven by co-occurring symptoms rather than being the direct result of the disease process.”
To further investigate factors contributing to perceived cognitive dysfunction in patients with SSc, Chen and colleagues conducted a cross-sectional survey. To be eligible for inclusion, patients were required to be aged 18 years or older, have a diagnosis of SSc from a physician, be able to read and respond to prompts in English and have internet access. The trial included 106 participants who were enrolled between September 2021 and January 2022.
The survey indicated age, sex, race, education level, employment status and disease subtype. Following disease and demographic characteristics, the survey also detailed information on perceived cognitive function, as measured by Patient-Reported Outcomes Measurement Information System (PROMIS) form, which assesses concentration, sharpness, thinking speed and memory function. The survey also collected data on symptoms and daily life function responses through the PROMIS FACIT-Fatigue short form.
According to the researchers, 56% of the included patients perceived “mild to severe” cognitive dysfunction, while 58% reported having the diffuse SSC disease subtype. Overall, receiving work disability benefits was significantly associated with worse perceived cognitive function ( = –5.41; 95% CI, –10.07 to –0.75). Those reporting higher levels of fatigue had also demonstrated significantly worse cognitive function ( = –0.37; 95% CI, –0.66 to –0.08). Meanwhile, older age appeared to be associated with better cognitive function ( = 0.19; 95% CI, 0.02-0.36).
“In examining the associations of common symptoms with perceived cognitive function, fatigue was uniquely associated with perceived cognitive dysfunction, though the effect size was not large,” Chen and colleagues wrote. “Although fatigue and pain are highly associated, the current study did not find a significant association between pain with perceived cognitive function.
“A more comprehensive study is needed to better understand symptom experience in SSc by disentangling cognition from other symptoms in time and examining their influence on everyday functioning,” they added.
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