Cognitive dysfunction in Sjögren's syndrome using the Montreal Cognitive Assessment Questionnaire and the Automated Neuropsychological Assessment Metrics: A cross-sectional study

Int J Rheum Dis. 2020 Aug;23(8):1019-1023. doi: 10.1111/1756-185X.13889. Epub 2020 Jun 30.

Abstract

Aim: To describe the prevalence of cognitive impairment and the most affected cognitive domains, employing the Montreal Cognitive Assessment (MoCA) and the Automated Neuropsychological Assessment Metrics (ANAM) of a Latin American primary Sjögren's syndrome (pSS) cohort, and compare these patients to secondary Sjögren's syndrome (sSS) subjects and controls.

Methods: This was a comparative cross-sectional study of patients with a diagnosis of pSS who fulfilled the American-European Consensus Group 2002 criteria and/or American College of Rheumatology/European League Against Rheumatism 2016 criteria; clinical information was evaluated prior to cognitive evaluation, which consisted of a single session in which the MoCA and ANAM were applied.

Results: A total of 122 subjects were included in the analysis (51 pSS, 20 sSS and 51 controls); mean age of pSS was 56 years (SD 10.4), of which 47 (92.15%) were women. Moderate-severe cognitive impairment by MoCA was 17% in pSS, 5% in sSS, and 15% in controls, and by ANAM were 29% in pSS and 10% in sSS (P > .05). Visuospatial/executive subdomain in the MoCA was different between the pSS and the control group (P = .005). We encountered a statistically significant difference between pSS patients and control scores from the program in 6 of the 7 domains tested by the ANAM.

Conclusion: No difference was found in the prevalence of cognitive impairment between pSS subjects and controls by MoCA. Several subdomain scores differed between groups in both scales. Evaluation of cognitive disorders in patients with SS, even in early stages of the disease, seems advisable but the best strategy is yet to be elucidated.

Keywords: Automated Neuropsychological Assessment Metrics; Montreal Cognitive Assessment; Sjögren's syndrome; cognitive dysfunction; neuropsychological tests.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Case-Control Studies
  • Cognition*
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology
  • Cross-Sectional Studies
  • Executive Function
  • Female
  • Humans
  • Male
  • Mental Status and Dementia Tests*
  • Mexico / epidemiology
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Severity of Illness Index
  • Sjogren's Syndrome / diagnosis
  • Sjogren's Syndrome / epidemiology*