Laura Plantinga1, Benjamin D Tift2, Charmayne Dunlop-Thomas1, S Sam Lim1, C Barrett Bowling3, Cristina Drenkard1. 1. Emory University, Atlanta, Georgia. 2. Edward Via College of Osteopathic Medicine, Spartanburg, South Carolina. 3. Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center, and Duke University, Durham, North Carolina.
Abstract
OBJECTIVE: To 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. METHODS: We 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. RESULTS: In the SLE patients, the mean balance score (3.7) and gait speed score (3.4) were high, while the mean 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. CONCLUSION: Our 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.
OBJECTIVE: To 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. METHODS: We 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 SLEpatients. 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. RESULTS: In the SLEpatients, the mean balance score (3.7) and gait speed score (3.4) were high, while the mean 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. CONCLUSION: Our results suggest a high prevalence of impairment across multiple domains of function in SLEpatients 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.
Authors: S Sam Lim; A Rana Bayakly; Charles G Helmick; Caroline Gordon; Kirk A Easley; Cristina Drenkard Journal: Arthritis Rheumatol Date: 2014-02 Impact factor: 10.995
Authors: Cristina Drenkard; Gaobin Bao; Greg Dennis; Hong J Kan; Priti M Jhingran; Charles T Molta; S Sam Lim Journal: Arthritis Care Res (Hoboken) Date: 2014-06 Impact factor: 4.794
Authors: E W Karlson; L H Daltroy; C Rivest; R Ramsey-Goldman; E A Wright; A J Partridge; M H Liang; P R Fortin Journal: Lupus Date: 2003 Impact factor: 2.911
Authors: Graciela S Alarcón; Gerald McGwin; América Uribe; Alan W Friedman; Jeffrey M Roseman; Barri J Fessler; Holly M Bastian; Bruce A Baethge; Luis M Vilá; John D Reveille Journal: Arthritis Rheum Date: 2004-06-15
Authors: Rasheeda K Hall; Carol Haines; Steven M Gorbatkin; Lynn Schlanger; Hesham Shaban; Jane O Schell; Susan B Gurley; Cathleen S Colón-Emeric; C Barrett Bowling Journal: J Am Geriatr Soc Date: 2016-07-05 Impact factor: 5.562
Authors: Abena A Twumasi; Anna Shao; Charmayne Dunlop-Thomas; Cristina Drenkard; Hannah L F Cooper Journal: Arthritis Res Ther Date: 2019-06-25 Impact factor: 5.156
Authors: Laura C Plantinga; Courtney Hoge; Charmayne Dunlop-Thomas; Brad D Pearce; S Sam Lim; Cristina Drenkard; C Barrett Bowling Journal: Lupus Sci Med Date: 2022-02
Authors: Laura C Plantinga; Grace Xu; Courtney Hoge; Ann Vandenberg; Charmayne Dunlop-Thomas; Brian D Jones; Jeremy Johnson; Cristina Drenkard; S Sam Lim; C Barrett Bowling Journal: Arthritis Care Res (Hoboken) Date: 2021-07-19 Impact factor: 5.178
Authors: Sierra Mendelsohn; Lina Khoja; Sofia Alfred; Jennifer He; Melanie Anderson; Denise DuBois; Zahi Touma; Lisa Engel Journal: Lupus Date: 2021-07-15 Impact factor: 2.911