Dementia, Cognitive Impairment, & Lupus

Difficulties with memory and recall are common challenges with lupus. And, new research suggests SLE can increase the risk of dementia.

Many Lupus Warriors experience feelings of confusion and forgetfulness as a result of lupus. In fact, surveys have shown that up to 60% of people with lupus will experience this symptom, known as brain fog.

Though not everyone reports battling this challenge, recent studies have shown that people with lupus struggle with memory.

A study published in 2014 looked into cognitive deficits and memory recall. The researchers matched 40 Lupus Warriors with 40 control participants. The average age of the participants was 33.3 +/- 9.7 years.

Memory was evaluated using:

• California Verbal Learning Test (CVLT)
• Wechsler Memory Test-Revised (WMS-R)
  • for verbal and visual paired words

The researchers found that people with lupus performed statistically worse on both visual and verbal memory. And, memory recall was also worse for people with lupus including measures of:

• immediate memory
• short delay free recall
• cued recall
• long delay free recall
• recognition correction

Central nervous system, dementia, & lupus

Lupus is an autoimmune disease that causes inflammation throughout the body, including the central and peripheral nervous system. Over time, this inflammation causes damage and inhibits function.

Because of this worry, researchers have explored the link between dementia and lupus. A study just published in November 2017 used the largest database in Israel, the Clalit Healthcare Database, to look for a connection.

The researchers retroactively compared 4,886 people with lupus (SLE) to 24,430 controls matched for age and sex.

The result: People with lupus had dementia at three-times the rate of control participants. 1.65% of Lupus Warriors had dementia compared to 0.51% of controls. Using a multivariate logistic regression analysis to account for other risk factors and age, the researchers concluded that people with lupus are 51% more likely to develop dementia in their lifetime.

Additional dementia research

Similar results were found in a study published in December 2016. This study was conducted in Taiwan using a nationwide cohort from 2004-2008.

For this study, there were 1,074 Lupus Warrior participants and 5,370 age- and sex-matched controls. The participants were followed for up to 7 years. Participants were measured if they received a diagnosis of dementia during the follow-up period.

The results: Lupus Warriors were more than twice as likely to develop dementia as compared to control participants (95% CI 1.26 – 3.63, P<0.001).

The dementia rates were:

• Lupus cohort: 357 per 100,000 person-years
• Comparator cohort: 180 per 100,000 person-years

Following the study, the researchers conducted a review of the literature and formed a hypothesis for the increased dementia rates. They identified anti-phospholipid antibodies as a potential contributing factor.

Anti-phospholipid antibodies can cause hyper-coagulability, which raises the risk of strokes.

Symptoms of dementia

With the increased risk of dementia for those with lupus, is is important to know the early signs. And, if you believe you or a loved one are experiencing the symptoms, be sure to bring it up with your lupus treatment team.

Symptoms of dementia include:

• Problems with abstract thinking
• Disorientation
  • Getting lost on familiar streets, for example
• Problems communicating
  • Forgetting simple words or using the wrong word
• Misplacing things
• Difficulty with common tasks
  • Challenges with cooking a meal
• Personality changes
  • Maybe becoming irritable, suspicious, or afraid
• Loss of initiative