Subjective Cognitive Dysfunction in Adults with Systemic Lupus Erythematosus Across the Lifespan
Funded Grant
Overview
Affiliation
View All
Overview
description
Despite recent advances in treatment of systemic lupus erythematosus (SLE), subjective cognitive dysfunction (CD) remains a pressing issue for many individuals with SLE. Adults with SLE are living longer, yet limited attention has been devoted to patient perspectives on the burden and impact of subjective CD, particularly among older adults in whom CD may be compounded by the effects of multimorbidity, polypharmacy, and other forms of dementia. In keeping with Stage 0 of the National Institutes of Health Stage Model for behavioral intervention development, the objective of this proposal is to 1) describe the perceived burden and impact of subjective CD among adults with SLE, including older adults, in individual semi-structured interviews and 2) determine the feasibility of characterizing daily fluctuations in subjective CD using novel application of ecological momentary assessment (EMA), a technique in which individualsĀf experiences are assessed repeatedly in real time. The specific aims are as follows: Aim 1: Elicit perspectives of adults .18 years of age with SLE on CD, associated factors, and impact on health-related quality of life, including in the context of aging. Informed by a phenomenological approach to qualitative study design, semi-structured interviews will be conducted to determine the essence of participantsĀf experiences related to subjective CD. A purposeful sampling strategy will be incorporated to ensure ample enrollment of older adults (.65 years of age). Aim 2: To determine the feasibility of characterizing daily fluctuations in subjective CD and associated factors in adults .18 years with SLE. Presence of subjective CD and associated patient-reported outcome measures will be assessed 5 times daily over 7 days using an EMA approach. Feasibility will be evaluated by recruitment and survey item completion. Semi-structured interviews will be conducted with a random subset of participants to explore factors impacting feasibility and acceptability. In secondary analyses, patterns of intra/interindividual daily fluctuations in subjective CD and associated factors will be investigated, including stratified by age. This project will generate preliminary data to support observational studies aimed at documenting daily patterns of subjective CD in larger samples over longer timeframes and in comparison with clinician- or selfadministered measures of objective CD, with the goal of developing evidence based patient-centered strategies to mitigate subjective CD in adults with SLE.
