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Paez-Venegas N, Jordan-Estrada B, Chavarria-Avila E, Perez-Vazquez F, Gómez-Bañuelos E, Medina-Dávalos R, Ontiveros-González JÁ, Diaz-Rubio GI, Navarro-Hernandez RE, Vázquez-Del Mercado M. The Montreal Cognitive Assessment Test: A Useful Tool in Screening of Cognitive Impairment in Patients With Systemic Lupus Erythematosus. J Clin Rheumatol 2019; 25:325-328. [PMID: 31764492 PMCID: PMC7597762 DOI: 10.1097/rhu.0000000000000876] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND/OBJECTIVE Systemic lupus erythematosus (SLE) is an inflammatory, chronic, and multisystemic disease, which may be associated with a wide range of neuropsychiatric manifestations, including cognitive impairment. Cognitive evaluations based on screening tests might identify early SLE-related cognitive alterations. The aim of this study was to evaluate and to compare the efficacy of three screening tests (Montreal Cognitive Assessment [MoCA], Mini Mental State Examination [MMSE], Cognitive Symptom Inventory [CSI]) against the gold standard (neuropsychological battery), in order to identify the most efficient screening test for cognitive impairment in patients with SLE. METHODS This observational cross-sectional study recruited 44 patients, from August to December 2017, who were diagnosed with SLE according to the Systemic Lupus International Collaborating Clinics (SLICC) Criteria 2012, and had no medical or psychiatric comorbidities. The patients were evaluated using the MoCA, MMSE, CSI, and the gold standard. Spearman's correlation and area under the curve analysis were performed; p < 0.05 was considered significant. RESULTS The MoCA test showed the highest correspondence with the gold standard (AUC = 99.4%, p < 0.001), sensitivity (84%), and specificity (100%). This was followed by the MMSE (AUC = 92.6%, p < 0.001; sensitivity, 54.8%; specificity, 100%) and the CSI (AUC = 30.6%, p < 0.05; sensitivity, 54.8%; specificity, 30.76%). CONCLUSION The MoCA is a brief, easily applied screening test that is highly effective for detecting cognitive impairment in SLE patients. It could be useful in clinical follow-up as a tool for early detection of cognitive alterations.
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Affiliation(s)
- Nicolas Paez-Venegas
- From the Instituto Jalisciense de Salud Mental (SALME), Secretaría de Salud Jalisco. Av. Zoquipan 1130, CP 44210, Zapopan, Jalisco, México
| | - Bethel Jordan-Estrada
- From the Instituto Jalisciense de Salud Mental (SALME), Secretaría de Salud Jalisco. Av. Zoquipan 1130, CP 44210, Zapopan, Jalisco, México
| | - Efrain Chavarria-Avila
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Departamento de Disciplinas Filosófico, Metodológico e Instrumentales, Sierra Mojada 950, 44340, Guadalajara, Jalisco, México
| | - Felipe Perez-Vazquez
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Sierra Mojada 950, Edificio P planta baja, 44340, Guadalajara, Jalisco, México
| | - Eduardo Gómez-Bañuelos
- Hospital Civil Dr. Juan I, Menchaca, División de Medicina Interna, Servicio de Reumatología PNPC 004086, CONACyT, Salvador Quevedo y Zubieta SN, 44340, Guadalajara, Jalisco, México
| | - Rafael Medina-Dávalos
- From the Instituto Jalisciense de Salud Mental (SALME), Secretaría de Salud Jalisco. Av. Zoquipan 1130, CP 44210, Zapopan, Jalisco, México
| | - José-Ángel Ontiveros-González
- From the Instituto Jalisciense de Salud Mental (SALME), Secretaría de Salud Jalisco. Av. Zoquipan 1130, CP 44210, Zapopan, Jalisco, México
| | - Gustavo-Ignacio Diaz-Rubio
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Sierra Mojada 950, Edificio P planta baja, 44340, Guadalajara, Jalisco, México
| | - Rosa E. Navarro-Hernandez
- From the Instituto Jalisciense de Salud Mental (SALME), Secretaría de Salud Jalisco. Av. Zoquipan 1130, CP 44210, Zapopan, Jalisco, México
| | - Mónica Vázquez-Del Mercado
- Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Instituto de Investigación en Reumatología y del Sistema Músculo Esquelético (IIRSME), Sierra Mojada 950, Edificio P planta baja, 44340, Guadalajara, Jalisco, México
- Hospital Civil Dr. Juan I, Menchaca, División de Medicina Interna, Servicio de Reumatología PNPC 004086, CONACyT, Salvador Quevedo y Zubieta SN, 44340, Guadalajara, Jalisco, México
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