SAT0418 Can the automated neuropsychological assessment metrics (ANAM) predict cognitive impairment compared to a comprehensive neuropsychological battery in patients with systemic lupus erythematosus (SLE)?

Abstract

Background The diagnosis of cognitive impairment (CI) is often delayed requiring use of a comprehensive battery (CB). The Automated Neuropsychological Assessment Metrics (ANAM) is a computerised tool that can be used to screen for CI. Objectives To determine the ability of ANAM (v4) GNS Battery to predict CI in patients with systemic lupus erythematosus (SLE). Methods SLE patients (n=98), aged 18-65 years, attending a single centre between July 2016-April 2017 were recruited. Participants were administered the ANAM and CB on the same day. ANAM throughput scores were used to provide an estimate of cognitive efficiency. Patient scores on the ANAM and CB were compared to a normative sample of age and gender-matched healthy controls. The CB evaluates the following major cognitive domains: manual motor speed and dexterity, simple attention and processing speed, visual-spatial construction, verbal fluency, learning and memory (visuospatial and memory), and executive functioning (untimed and timed). ANAM evaluates the following major cognitive domains: attention and processing speed, memory, visual-spatial processing, executive functioning, abstract language function and fine motor processing. CI was operationalized on the CB and ANAM as a z-score of ≤-1.5 on≥2 domains or a z-score ≤-2.0 on≥1 domains, or either. The performance of ANAM was compared against the CB using different CI definitions. Descriptive analysis was used to determine prevalence, sensitivity (Sn), specificity (Sp), Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Results Of the 98 patients (90.8% female), the mean age at SLE diagnosis was 28.5±10.2 and disease duration at enrolment was 15.5±10.0 years. Prevalence of CI using CB ranged between 40.0%-44.8% (z≤-1.5 in≥2 domains and z≤-2.0 in≥1 domains, respectively) and 55.2% for either. Prevalence of CI using the ANAM ranged between 30.8%-39.3%% (z≤-1.5 in≥2 domains and z≤-2.0 in≥1 domains, respectively) and 43.0% for either. ANAM Sn/Sp was 52/73% and PPV/NPV was 70/55% [based on z≤-1.5 in≥2 domains or z≤-2.0 in≥1 domains for ANAM and CB (corresponding for A+B and E+F in table 1)]. Abstract SAT0418 - Table 1 Performance of ANAM against the CB Definitions of CI Comprehensive Battery (CB)