ArticleACR open rheumatology2023
Intraindividual Change in Cognitive Function Among Adults With Systemic Lupus Erythematosus: A Markov Analysis Over 7 Years.
Article in ACR open rheumatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Intraindividual cognitive function course over time in patients with systemic lupus erythematosus.RMD open · 2025Article
- Variable Selection for Progressive Multistate Processes Under Intermittent Observation.Statistics in medicine · 2025Article
- Relationship Between Cognitive Impairment and Quality of Life in Systemic Lupus Erythematosus: A Multimodal Neuroimaging Perspective.International journal of general medicine · 2025Review
- Fluid Cognition Among Individuals With Systemic Lupus Erythematosus.Arthritis care & research · 2024Article
- Outcome clusters and their stability over 1 year in patients with SLE: self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life.Lupus science & medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveCognitive impairment is prevalent in systemic lupus erythematosus (SLE). There remain gaps in understanding cognition and SLE longitudinally. We studied intraindividual change in cognition in SLE over time.
methodsData were from the University of California, San Francisco Lupus Outcome Study, which included 1281 adults with SLE. The Hopkins Verbal Learning Test-Revised (HVLT-R) and the Controlled Oral Word Association Test (COWAT) were administered annually over 7 years. A two-state Markov analysis was used to model transition intensities for probabilities of change in cognition. Logistic regression examined the association between clinical variables and cognitive change.
resultsMinimal transition between cognitive states was observed in the Markov analysis. Using the COWAT, higher levels of self-reported depression were associated with decreased likelihood of cognitive improvement (Relative Risk [RR]: 0.98; 95% confidence interval [CI]: 0.96-0.99), and higher self-reported disease severity was associated with cognitive decline (RR: 1.05; 95% CI: 1.02-1.09). Using the HVLT-R, increasing age (RR: 1.02; 95% CI: 1.01-1.03) and higher education level (RR: 1.82; 95% CI: 1.28-2.58) were associated with cognitive improvement, and higher self-reported disease severity (RR: 1.02; 95% CI: 1.01-1.03) and depression (RR: 1.05; 95% CI: 1.03-1.07) were associated with cognitive decline.
conclusionMost individuals with SLE did not transition between states of high (Z score ≥ -1.5) or low (Z score < -1.5) cognition in a Markov analysis over a 7-year assessment period, highlighting a degree of relative stability in cognition over time. Increasing age and higher education levels were associated with greater likelihood of cognitive improvement. Greater self-reported SLE disease severity and depression were associated with cognitive decline.
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Registered trials
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