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Objective: Neuropsychiatric System Lupus Erythematosus (NP-SLE) is a subtype of SLE characterized by chronic or episodic neurologic and/or psychiatric central nervous system features. The neuropsychological profile of NP-SLE is not well-established. Here we present serial evaluations of a woman with confirmed NP-SLE who underwent subsequent medical intervention. This case study adds to the growing body of literature demonstrating the role neuropsychology plays in the care of patients with NP-SLE. Method: This was an evaluation of a 25-year-old woman with NP-SLE. Initial testing took place inpatient prior to treatment with immunotherapy treatment subsequent evaluations were outpatient at 1 month, 4 months and 8 months post-treatment. Results: Inpatient evaluation revealed a woman of at least average premorbid abilities with suboptimal performances across cognitive domains including reduced speed of processing and notable difficulty with planning and organization. Evaluation 1 month later evidenced worsening cognitive and motoric performances across tasks which led to adjustment of medical management. Evaluation at 4 months demonstrated a positive trend and some improved cognitive functioning; 8-month evaluation confirmed improvement in global cognition and functioning with suspected return to premorbid abilities. Conclusions: This case provides an example of NP-SLE neuropsychological profile over time and demonstrates the beneficial impact of correct diagnosis and medical regimen. It also highlights the role of serial neuropsychological assessment in the management of complex neurological disease. [ABSTRACT FROM AUTHOR]

Objective: To demonstrate the validity of the Symbol Match in a diverse clinical setting. Background: To improve detection of cognitive impairment in older primary care patients, our team developed the 5-Cog, a 5-minute cognitive assessment and decision tree paradigm that can be administered by non-clinicians. The Symbol Match is a new 90-second oral symbol and digit substitution task that is one of the three tests in the 5-Cog that assesses processing speed and executive function. Methods: 50 participants (66% female; 44% Hispanic, 38% Non-Hispanic Black; 36% evaluated in Spanish) with a mean age of 77.84 ± 7.3, and 12 ± 4.7 mean years of education. Participants were recruited following clinical evaluations at the Montefiore Memory Disorder Centers and had confirmed clinical diagnoses of dementia, mild cognitive impairment (MCI), or subjective cognitive concerns (SCC). Results: Symbol Match scores were significantly different (p < 0.001) between participants with SCC (N = 5, M = 48 ± 9.7), MCI (N = 14, M = 31.7 ± 14.3), and dementia (N = 28, M = 9.6 ± 11.5). Age (p = 0.004) and education (p < 0.001) were correlated with Symbol Match score in the overall sample. Symbol Match scores were significantly different between the 3 disease states (p < 0.001) even when controlling for age and education. The Symbol Match was highly correlated (r = 0.843, p < 0.001) with the Symbol Digit Modalities Test (SDMT), an established neuropsychological measure of processing speed and executive function. Conclusion: This study provides initial validation of the Symbol Match and its utility in a clinical population. Further research on psychometric properties and construct validity of this new tool is needed. [ABSTRACT FROM AUTHOR]

Objective: The Symbol Digit Modalities Test (SDMT) is a task of processing speed and executive functioning that is widely used to evaluate individuals with Multiple Sclerosis (MS) and has been shown to predict various instrumental activities of daily living. The relationship between SDMT and daily functioning has not been well explored in the aging population. The Activities of Daily Living-Prevention Instrument (ADL-PI) is a self-report measure that assesses changes in functioning and instrumental activities of daily living (IADLs). We evaluate the relationship between SDMT and ADL-PI in older adults with subjective cognitive complaints in an urban, multi-ethnic, primary care population in Bronx, New York. Methods: 300 participants (50.7% Hispanic, 43.7% non-Hispanic Black; 37% assessed in Spanish) completed the SDMT and ADL-PI as part of a larger study seeking to improve detection of cognitive impairment in primary care. The mean age of the sample was 71.35 ± 5.76 years and participants had a mean 12.26 ± 3.76 years of education. Pearson correlations were used to examine the relationship between SDMT and IADLs. Results: SDMT performance was weakly albeit significantly correlated with self-report of functional difficulties on the ADL-PI (r = −0.312, p < 0.001). The relationship between SDMT (Range = 1–51, M = 25.39) and ADL-PI was significant in both English (p < 0.0011) and Spanish (p = 0.004) speaking participants and remained significant when controlling for age, education, and depression (p = 0.002). Conclusion: Consistent with MS literature, the SDMT is a useful tool for predicting self-report of instrumental activities of daily living of older adults with cognitive concerns. [ABSTRACT FROM AUTHOR]